Prognosticators of first line treatment for metastatic uveal melanoma (MUM).
Bibliographic record
Abstract
9570 Background: Prognosis of MUM is poor yet there is significant inter-patient variability. Delineation of novel prognostic factors in MUM patients may enable stratified treatment algorithms. Methods: We performed a retrospective review of patients who presented with MUM from September 2004 to January 2016 at the Princess Margaret Cancer Centre, Toronto. Information on age, gender, liver involvement, size of largest liver mets, extrahepatic disease, ECOG, and laboratory values (hemoglobin, neutrophil/lymphocyte ratio (NLR), LDH, and ALP) were obtained at diagnosis of MUM. Associations with overall survival (OS), systemic 1stline treatment outcome (clinical benefit (stable disease, partial and complete responses) vs. progressive disease) and time to relapse were explored by univariable and multivariable analysis. Results: We analyzed 132 patients, 41% male with a median age of 58 years (12 - 90 years). 92% presented with liver mets. 79 patients underwent 1st line treatment with the most common being carboplatin and paclitaxel (19%), surgery (16%) or dacarbazine (13%). Age by univariable analysis significantly affected treatment outcome (OR 0.95 p = 0.01) with a trend to inferior outcome with presence of liver mets (OR = 0.13 p = 0.06). Multivariable analysis showed absence of liver mets (p = 0.03) or bone mets (p = 0.04) to predict superior treatment outcome whilst increasing age (p = 0.009) predicted inferior response. Time to relapse after 1st line therapy was affected by liver mets (HR = 2.89 p = 0.02). LDH (HR = 1.00 p < 0.001), ALP (HR = 1.004 p < 0.001), age (HR = 1.02, p = 0.006), NLR (HR = 1.08, p = 0.0135), ECOG (HR 2.21, p = 0.0083), and liver mets (HR = 2.7 p = 0.0102) were significant for OS. Multivariable analysis showed LDH (p = 0.02) was the only significant predictor for time to relapse while LDH (p = 0.0004), age (p = 0.0007), and ECOG (p = 0.0002) were significant prognosticators for OS. Conclusions: Potential predictive factors for treatment response, time to relapse, and OS were highlighted. Further validation is required to assess utility in stratifying 1st line treatment algorithms for MUM patients.
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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 | 0.000 |
| 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".