Baseline characteristics as predictors of adjuvant chemotherapy (AC) discontinuations and modifications in stage III colorectal cancer (CRC) patients.
Bibliographic record
Abstract
585 Background: Discontinuations and treatment modifications of AC can impact survival in CRC patients. Unfavorable baseline patient characteristics such as old age, poor ECOG performance status, and comorbidities may contribute to early treatment termination, but their precise associations with treatment interruptions are unclear. Methods: We reviewed a population-based cohort of CRC patients treated with adjuvant monotherapy (Capecitabine) or combination therapy (FOLFOX or CAPOX) within 12 weeks of curative resection in British Columbia, and determined the associations between baseline characteristics and treatment modifications (change in regimen and/or cessation of a single agent) or discontinuations. Results: Among 555 patients, median age was 66 years, 52% were men, and 16% were ECOG ≥2. In this cohort, 42% received monotherapy and 58% received combination therapy. 37% of patients had modifications to monotherapy and 31% discontinued it while 44% had modifications to combination therapy and 26% discontinued it. For monotherapy, univariate analyses showed significant associations between survival and treatment modifications ( P= 0.001) and discontinuations ( P< 0.001). Specifically, old age (≥70; P= 0.044) and pre-treatment anemia ( P= 0.016) were associated with permanent discontinuations. On multivariate analyses, non-mucinous adenocarcinoma histology predicted a higher chance of treatment modifications (OR 3.02, 95% CI 1.03-8.83, P= 0.044) while pre-treatment anemia was correlated with discontinuations (OR 2.27, 95% CI 1.14-4.50, P= 0.020). Univariate analyses of combination therapy showed a relationship between survival and discontinuations ( P= 0.005); however, only worse ECOG status (≥2) was predictive of discontinuations on multivariate analyses (OR 2.39, 95% CI 1.03-5.55, P= 0.042). Conclusions: Except for pre-treatment anemia and ECOG status, few baseline characteristics correlated with treatment modifications or discontinuations, underscoring the need for repeated clinical assessments throughout treatment. Baseline features may only be useful in deciding whether or not a patient should initiate chemotherapy.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".