Enzalutamide with or without leuprolide in patients with high-risk biochemically recurrent prostate cancer: EMBARK post hoc analysis by age
Bibliographic record
Abstract
INTRODUCTION: The EMBARK trial demonstrated that enzalutamide ± leuprolide significantly improved metastasis-free survival (MFS) in patients with nonmetastatic castration-sensitive prostate cancer with high-risk biochemical recurrence (hrBCR). This post hoc analysis reports the efficacy and safety results when patients were stratified by age. METHODS: The EMBARK trial (NCT02319837) included patients with hrBCR after local therapy, prostate-specific antigen (PSA) doubling time ≤ 9 months, and PSA ≥ 2 ng/mL above nadir post radiotherapy (RT) or ≥ 1 ng/mL after radical prostatectomy ± postoperative RT. Patients were randomized (1:1:1) to enzalutamide with leuprolide (combination), leuprolide and placebo (leuprolide alone), or enzalutamide alone (monotherapy). This analysis compares MFS and safety outcomes by age group (<70 vs ≥70 years). RESULTS: Of 1068 patients, 543 (51 %) were aged < 70 years and 525 (49 %) were aged ≥ 70 years. Patients ≥ 70 years had higher median baseline PSA and higher rates of primary RT versus patients < 70 years across all treatment groups. Improvements in MFS were observed in the combination and monotherapy groups compared with leuprolide alone, regardless of age. Treatment-related serious adverse events (TRSAEs) and grade ≥ 3 AEs were more common in patients aged ≥ 70 years versus < 70 years for all treatment groups, but TRSAEs were low in all treatment and age groups (TRSAEs: 0.6-11.7 %; grade ≥3 AEs: 36.3-60.1 %). CONCLUSION: Clinically meaningful improvements in MFS were observed following enzalutamide ± leuprolide in patients with hrBCR regardless of age. TRSAEs were more common in older patients but were low regardless of age. These findings should be interpreted in light of small subgroup sizes.
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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 | 0.005 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.004 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".