Enzalutamide shows sustained overall survival improvement in patients with metastatic hormone‐sensitive prostate cancer
Bibliographic record
Abstract
Long-term follow-up of the ENZAMET (Enzalutamide in First Line Androgen Deprivation Therapy for Metastatic Prostate Cancer) trial shows sustained improved overall survival for men with metastatic hormone-sensitive prostate cancer treated with the addition of enzalutamide (ENZA) to testosterone suppression.1 The results confirm the short-term improved survival benefits seen in an interim analysis. “ENZAMET has the longest follow-up of all of the studies of direct potent androgen receptor inhibitors added to testosterone suppression and [is] the only study able to report the long-term follow-up for all the prognostic groups,” says the lead author of the study, Christopher Sweeney, MBBS, director of the South Australian immunoGENomics Cancer Institute at the University of Adelaide. The ENZAMET trial is an international, open-label, randomized, phase 3 trial in which 1125 patients with metastatic hormone-sensitive prostate cancer from 83 sites in six countries (Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States) were randomized to receive ENZA plus testosterone suppression (n = 563) or to a control group of testosterone suppression with nonsteroidal antiandrogen therapy with bicalutamide, nilutamide, or flutamide (n = 562). All patients were at least 18 years old with an Eastern Cooperative Oncology Group performance status score of 0–2. Patients were stratified by disease volume, comorbidities, planned use of concurrent docetaxel (allowed for up to six cycles once every 3 weeks), and bone antiresorptive therapy. At a median follow-up of 68 months, the median overall survival was not reached by either the ENZA group or the control group (hazard ratio [HR], 0.70; 95% CI, 0.58–0.84; p < .001) with 5-year overall survival rates of 67% (95% CI, 63%–70%) and 57% (95% CI, 53%–61%) in the ENZA and control groups, respectively. The benefits to overall survival seen in the ENZA group compared to the control group were seen across prognostic groups. For low- and high-volume disease, the HRs were 0.54 and 0.79, respectively. For patients treated with planned docetaxel or no planned docetaxel, the HRs were 0.82 and 0.60, respectively. For patients treated with docetaxel, the HR was 0.73 for those with synchronous metastatic disease and 1.10 for those with metachronous metastatic disease.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.002 | 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".