Effects of Enzalutamide on the Sexual Activity of Patients with Biochemically Recurrent Prostate Cancer: A Post Hoc Analysis of Patient-reported Outcomes in the EMBARK Study
Bibliographic record
Abstract
A post hoc analysis for the EMBARK trial showed better maintenance of sexual activity—interest, activity, satisfaction, and erectile function—with enzalutamide monotherapy than with leuprolide alone. For patients who were interested in sex or were sexually active before starting treatment, enzalutamide monotherapy was more effective in preserving sexual activity than leuprolide alone. EMBARK demonstrated prolonged metastasis-free survival with enzalutamide ± leuprolide versus leuprolide alone for patients with high-risk biochemical recurrence of prostate cancer, with health-related quality of life (HRQoL) maintained. To evaluate treatment effects on sexual activity (SA), item-level analyses of SA-related HRQoL were performed. HRQoL was assessed (baseline, every 12 wk) until metastasis or death. Time to confirmed clinically meaningful deterioration (TTCD; confirmed at next visit) and longitudinal changes in HRQoL were examined using Cox regression and mixed-model repeated measures analyses, respectively. In comparison to leuprolide alone, enzalutamide monotherapy delayed TTCD in interest in sex (8.5 vs 5.6 mo; hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.57–0.87; p < 0.001), extent of SA (5.7 vs 3.0 mo; HR 0.69, 95% CI 0.54–0.90; p = 0.004), satisfaction with sex life (11.1 vs 5.4 mo; HR 0.61, 95% CI 0.45–0.84; p = 0.001), and erectile function (5.5 vs 2.9 mo; HR 0.67, 95% CI 0.50–0.88; p = 0.003). TTCD in SA-related HRQoL was similar with enzalutamide + leuprolide and leuprolide alone, except TTCD in erectile function was shorter by a statistically significant median of 0.1 mo (3 d), which is not clinically meaningful. Longitudinally, no clinically meaningful changes for any SA-related item were observed from baseline to week 205 in any group. SA-related HRQoL preservation seems to be better with enzalutamide monotherapy than with leuprolide alone.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| 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 | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".