Assessing the real-world (RW) efficacy and toxicity of docetaxel (D) for the treatment of metastatic castrate sensitive prostate cancer (mCSPC): A single institution experience.
Bibliographic record
Abstract
270 Background: While D has been shown to prolong survival and improve quality of life in men with mCSPC in clinical trial settings, less is known about its effectiveness in the RW setting. Furthermore, it is uncertain whether the timing of D affects toxicity and outcome. We aimed to identify effectiveness and toxicity outcomes as well as patient (pt) characteristics and prescribing patterns at our institution. Methods: In this retrospective chart analysis, we identified 70 pts with mCSPC who were treated with D between June 2014 and September 2018 at an academic cancer centre in Toronto. The main outcomes studied included time to castrate resistance (TCR), change in PSA, number of cycles completed, and rates of febrile neutropenia (FN). We also analyzed pt subgroups including pts starting D <50 days after the start of androgen deprivation therapy (ADT) versus those starting >50 days after ADT initiation. Results: The median age of our pts was 69 (IQR: 64-74). The median follow-up time was 598 days. 79% of pts had high volume disease per CHAARTED criteria, 73% had de novo metastatic disease and 85% had bone-only disease. The median TCR from the start of ADT was 12.3 months. The median change in PSA from pre-ADT to post-D nadir was 99%. The mean D dose intensity was 86% of the ideal dose and 91% of pts completed all 6 cycles of D. 11% of pts were diagnosed with FN during treatment. 6% of pts required treatment delays and 19% required toxicity-related dose reductions. Subgroup analysis showed that patients (n=41) who received D >50 days from the start of ADT did not have significant differences in TCR, rates of FN, need for a decrease in dose intensity or treatment delays compared to those starting <50 days after ADT (n=29). Conclusions: D can be delivered safely in RW pts, with low rates of FN, however, there is evidence of an efficacy-effectiveness gap with a shorter TCR compared to that observed in CTs. The timing of D (<50 days vs. >50 days) does not appear to have an impact on outcome or toxicity.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".