Evidence map›Paper›PMID 30260754›Full record

ArticleJournal of global oncology2018

Metastatic Castration-Resistant Prostate Cancer Previously Treated With Docetaxel-Based Chemotherapy: Treatment Patterns From the PROXIMA Prospective Registry.

Hideyuki Akaza, Giuseppe Procopio, Choosak Pripatnanont, Gaetano Facchini, Sergio Fava, Duncan Wheatley, Kwong Chuen Leung, Mohammad Butt, Alberto Silva, Liliana Castillo and 5 more

Open access · goldAbstract read
In one paragraph

Article in Journal of global oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Review
  11. Review
  12. Article
  13. Article
  14. Review
  15. Article
  16. Article
  17. Article
  18. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 1 institution in 1 country.

Hideyuki AkazaHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Giuseppe ProcopioHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Choosak PripatnanontHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Gaetano FacchiniHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Sergio FavaHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Duncan WheatleyHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Kwong Chuen LeungHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Mohammad ButtHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Alberto SilvaHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Liliana CastilloHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Vasilios KaravasilisHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Ayse ӦzatılganHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Simon HitierHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Evelyne B Ecstein-FraisseHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Mustafa ӦzgüroḡluHideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.
Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale" · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThere is a major clinical need to devise an optimal treatment sequence for the multiple therapy options available for patients with metastatic castration-resistant prostate cancer (mCRPC). In the absence of prospective clinical trials, sequencing information can be derived from large, real-world registry studies. PATIENTS AND

methodsPROXIMA (Treatment Patterns in Patients With Metastatic Castration-Resistant Prostate Cancer Previously Treated With Docetaxel-Based Chemotherapy) is a large, global, prospective registry study evaluating real-world treatment patterns of patients with mCRPC who experience disease progression during or after docetaxel therapy. Patients were enrolled worldwide between 2011 and 2014. Treatments were determined by the treating physicians and recorded in categories of chemotherapy, hormonal therapy, targeted therapy, immunotherapy, and palliative therapy. Treatment sequencing patterns, response to treatment, and types of progression were recorded and analyzed. Progression-free survival and overall survival with different treatment modalities were analyzed using Kaplan-Meier method.

resultsTreatment patterns were evaluated in 903 patients. Therapy selection was influenced by region. Hormonal therapy (57.5%) and taxane chemotherapy (26.4%) were the most frequently administered first subsequent treatments after docetaxel. Tumor responses to first subsequent treatment were observed in 22.6% of evaluable patients. Overall survival and progression-free survival did not differ significantly across different treatment modalities.

conclusionIdentifying an optimal treatment sequence is vital for improving the care of patients with mCRPC. The PROXIMA registry provided a representative sample of global data on real-world treatment patterns for patients with mCRPC previously treated with docetaxel. These data can be used to devise optimal therapy sequences and inform treatment decisions.

Indexed as

RegistriesAgedAndrogen AntagonistsAndrostenesAntineoplastic Combined Chemotherapy ProtocolsDisease-Free SurvivalDocetaxelHumansKaplan-Meier EstimateMaleMiddle AgedNeoplasm MetastasisProspective StudiesProstate-Specific AntigenProstatic Neoplasms, Castration-ResistantTreatment OutcomeAndrogen AntagonistsAndrostenesDocetaxelProstate-Specific Antigen

Identifiers

PMID30260754
PMCPMC6223517
OpenAlexW2893735442

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.