Evidence map›Paper›PMID 39143030›Full record

ArticleCancer medicine2024

Survival by first-line therapy and prognostic group among men with metastatic castration-resistant prostate cancer.

Megan E V Caram, Kyle Kumbier, Phoebe A Tsao, Jennifer Burns, Jordan B Sparks, Kristian D Stensland, Zachery R Reichert, Joshi J Alumkal, Brent K Hollenbeck, Vahakn Shahinian and 2 more

Abstract read
In one paragraph

Article in Cancer medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
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

12 authors.

Megan E V CaramDepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.ORCID 0000-0003-1597-5428
Kyle KumbierVA Health Services Research & Development, Center for Clinical Management and Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.
Phoebe A TsaoDepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.ORCID 0000-0002-8694-3186
Jennifer BurnsVA Health Services Research & Development, Center for Clinical Management and Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.
Jordan B SparksVA Health Services Research & Development, Center for Clinical Management and Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.ORCID 0000-0002-1289-5476
Kristian D StenslandDepartment of Urology, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0002-3765-3393
Zachery R ReichertDepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Joshi J AlumkalDepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Brent K HollenbeckDepartment of Urology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Vahakn ShahinianDepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Alexander TsodikovDepartment of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Ted A SkolarusVA Health Services Research & Development, Center for Clinical Management and Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.

Funding

XenograftP30CA046592 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Alexey I Nesvizhskii · 1988 to 2026
$178.2M
Tissue/InformaticsP50CA186786 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Ganesh S Palapattu · 2014 to 2026
$27.6M
Modeling Precision Interventions for Prostate Cancer ControlU01CA253915 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI ETZIONI, RUTH D, TSODIKOV, ALEXANDER · 2020 to 2025
$6.5M
De-implementation of low value castration for men with prostate cancerR37CA222885 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SAINI, SAMEER DEV, SKOLARUS, TED ALBERT · 2018 to 2023
$3.6M
Physician dispensing of oral specialty drugs for advanced prostate cancer and its implications for patientsR01CA275993 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLENBECK, BRENT K., SHAHINIAN, VAHAKN B · 2023 to 2025
$2.5M
Refining castration use for recurrent prostate cancerR01CA242559 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SKOLARUS, TED ALBERT, TSODIKOV, ALEXANDER · 2020 to 2023
$1.4M
Building capacity for clinical trial improvement through implementation scienceF32CA264874 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI STENSLAND, KRISTIAN DONALD · 2021 to 2021
$84k
NCI NIH HHS F32 CA264874NCI NIH HHS P30 CA046592NCI NIH HHS P50 CA186786NCI NIH HHS R01 CA242559NCI NIH HHS R01 CA275993NCI NIH HHS R37 CA222885NCI NIH HHS U01 CA253915Prostate Cancer Foundation
6 · The paper itself

Abstract

introductionMetastatic castration-resistant prostate cancer (mCRPC) is a heterogeneous disease with prognoses varying from months to years at time of castration-resistant diagnosis. Optimal first-line therapy for those with different prognoses is unknown.

methodsWe conducted a retrospective cohort study of men in a national healthcare delivery system receiving first-line therapy for mCRPC (abiraterone, enzalutamide, docetaxel, or ketoconazole) from 2010 to 2017, with follow-up through 2019. Using commonly drawn prognostic labs at start of mCRPC therapy (hemoglobin, albumin, and alkaline phosphatase), we categorized men into favorable, intermediate, or poor prognostic groups depending on whether they had none, one to two, or all three laboratory values worse than designated laboratory cutoffs. We used Kaplan-Meier methods to examine prostate specific antigen (PSA) progression-free and overall survival (OS) according to prognostic group and first-line therapy, and multivariable cox regression to determine variables associated with survival outcomes.

resultsAmong 4135 patients, median PSA progression-free survival (PFS) was 6.9 months (95% confidence interval [CI] 6.6-7.3), and median OS 18.8 months (95% CI 18.0-19.6), ranging from 5.7 months (95% CI 4.8-7.0) in the poor prognosis group to 31.3 months (95% CI 29.7-32.9) in the favorable group. OS was similar regardless of initial treatment received for favorable and intermediate groups, but worse for those in the poor prognostic group who received ketoconazole (adjusted hazard ratio 2.07, 95% CI 1.2-3.6). PSA PFS was worse for those who received ketoconazole compared to abiraterone across all prognostic groups (favorable HR 1.76, 95% CI 1.34-2.31; intermediate HR 1.78, 95% CI 1.41-2.25; poor HR 8.01, 95% CI 2.93-21.9).

conclusionCommonly drawn labs at mCRPC treatment start may aid in predicting survival and response to therapies, potentially informing discussions with care teams. First-line treatment selection impacts disease progression for all men with mCRPC regardless of prognostic group, but impacted OS only for men with poor prognosis at treatment start.

Indexed as

AndrostenesDocetaxelKetoconazolePhenylthiohydantoinProstatic Neoplasms, Castration-ResistantAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsBenzamidesHumansKaplan-Meier EstimateMaleMiddle AgedNitrilesPrognosisProgression-Free SurvivalabirateroneAndrostenesBenzamidesDocetaxelenzalutamideKetoconazoleNitrilesPhenylthiohydantoinProstate-Specific Antigennovel therapiesprognosisprostate cancer

Identifiers

PMID39143030
PMCPMC11193054

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Registered trials

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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.