Prostate-specific antigen (PSA) trajectories correlate with overall survival (OS) in men treated with abiraterone acetate plus prednisone (AA+P) or placebo plus prednisone: A post-hoc analysis of COU-AA-301 trial data.
Bibliographic record
Abstract
e16528 Background: Treatment options for men with metastatic castration-resistant prostate cancer (mCRPC) have been expanding. AA+P is one therapy that prolongs OS in men with mCRPC. However, it remains challenging to predict the prognosis of men shortly after starting therapy. We identified patterns of PSA change over time (trajectories) for men in the COU-AA-301 trial and examined the association between PSA trajectory and OS. Methods: Data from both treatment arms of the COU-AA-301 trial were used, restricting to men with ≥6 months of follow-up. Log PSA at the first 2 visits post-randomization (84 and 168 days) was used in a modelling procedure to stratify men into 3 groups, each comprised of men with a differing PSA trajectory. Univariate Cox regression assessed the association between trajectory group and OS. Among AA+P patients, predictors of a better trajectory group were identified using multivariate multinomial logistic regression. Results: A total of 913 men (634 AA+P; 279 placebo) were included in the analysis. Group 1 had the lowest mean PSA at both visits post-randomization while Group 3 had the highest. The percent of men in each group and associations with OS are shown in the table. AA+P treated men were more likely to be in a favorable group. Versus Group 1, risk of death was 2.8 and 4.9 times higher in Group 2 and 3, respectively. Exploratory modelling among AA+P patients identified that older age and higher baseline log PSA were among the most important predictors of being assigned to a worse PSA trajectory group (Group 2 or 3 vs 1). Conclusions: In a post-hoc analysis of COU-AA-301 trial data, 3 PSA trajectories over the first 6-months post-randomization were identified and correlated with OS. AA+P treated men were more likely to have a favorable PSA trajectory. The findings suggest that AA+P may be associated with PSA changes post-initiation that may in turn predict survival, although further study is needed. [Table: see text]
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".