Evidence Based Medicine on FHIR Implementation Guide
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Evidence Based Medicine on FHIR Implementation Guide, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot3 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/ebm/ and changes regularly. See the Directory of published versions

: 19029421 Phase III trial of androgen ablation with or without three cycles of systemic chemotherapy for advanced prostate cancer.

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    <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><p class="res-header-id"><b>Generated Narrative: Citation 179631</b></p><a name="179631"> </a><a name="hc179631"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 21; Last updated: 2025-10-13 12:34:35+0000; Language: en</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-journal-article-citation.html">JournalArticleCitation</a></p></div><p><b>ArtifactPublicationStatus</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-status-type active}">Active</span></p><p><b>url</b>: <a href="https://fevir.net/resources/Citation/179631">https://fevir.net/resources/Citation/179631</a></p><p><b>identifier</b>: FEvIR Object Identifier/179631, <code>https://pubmed.ncbi.nlm.nih.gov</code>/19029421</p><p><b>title</b>: 19029421 Phase III trial of androgen ablation with or without three cycles of systemic chemotherapy for advanced prostate cancer.</p><p><b>status</b>: Active</p><p><b>author</b>: Computable Publishing®: MEDLINE-to-FEvIR Converter: </p><p><b>publisher</b>: Computable Publishing LLC</p><p><b>contact</b>: <a href="mailto:support@computablepublishing.com">support@computablepublishing.com</a></p><p><b>description</b>: </p><div><p>This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide.</p>
</div><h3>UseContexts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td><a href="http://terminology.hl7.org/7.1.0/CodeSystem-citation-classification-type.html#citation-classification-type-fevir-platform-use">Citation Classification Type: fevir-platform-use</a> (FEvIR Platform Use)</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier medline-base}">Medline Base</span></td></tr></table><p><b>copyright</b>: </p><div><p>https://creativecommons.org/licenses/by-nc-sa/4.0/</p>
</div><p><b>approvalDate</b>: 2009-01-13</p><p><b>lastReviewDate</b>: 2023-02-02</p><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/citation-classification-type citation-source}">Citation Source</span></p><p><b>classifier</b>: <span title="Codes:">MEDLINE</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/citation-classification-type medline-owner}">MEDLINE Citation Owner</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#owner_value NLM}">National Library of Medicine, Index Section</span></p></blockquote><p><b>currentState</b>: <span title="Codes:{http://hl7.org/fhir/citation-status-type medline-medline}">Medline Citation Status of Medline</span>, <span title="Codes:{http://hl7.org/fhir/citation-status-type pubmed-publication-status-ppublish}">PubMed PublicationStatus of ppublish</span></p><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title="Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-pubmed}">PubMed Pubstatus of Pubmed</span></p><p><b>period</b>: ?? --&gt; 2008-11-26 09:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title="Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-medline}">PubMed Pubstatus of Medline</span></p><p><b>period</b>: ?? --&gt; 2009-01-14 09:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title="Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-entrez}">PubMed Pubstatus of Entrez</span></p><p><b>period</b>: ?? --&gt; 2008-11-26 09:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title="Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-pmc-release}">PubMed Pubstatus of PMC release</span></p><p><b>period</b>: ?? --&gt; 2009-12-20</p></blockquote><blockquote><p><b>citedArtifact</b></p><p><b>identifier</b>: <code>https://pubmed.ncbi.nlm.nih.gov</code>/19029421, <code>https://www.ncbi.nlm.nih.gov/pmc/</code>/PMC3864402, <code>https://doi.org</code>/10.1200/JCO.2007.15.9830, pii/JCO.2007.15.9830</p><h3>Titles</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/title-type primary}">Primary title</span></td><td><div><p>Phase III trial of androgen ablation with or without three cycles of systemic chemotherapy for advanced prostate cancer.</p>
</div></td></tr></table><h3>Abstracts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-abstract-type primary-human-use}">Primary human use</span></td><td><div><p><strong>PURPOSE:</strong> We conducted a phase III trial in patients with previously untreated metastatic prostate cancer to test the hypothesis that three 8-week cycles of ketoconazole and doxorubicin alternating with vinblastine and estramustine, given in addition to standard androgen deprivation, would delay the appearance of castrate-resistant disease.
<strong>PATIENTS AND METHODS:</strong> Eligible patients had metastatic prostate cancer threatening enough to justify sustained androgen ablation and were fit enough for chemotherapy. The primary end point was time to castrate-resistant progression as shown by increasing prostate-specific antigen, new radiographic lesions, worsening cancer-related symptoms, or receipt of any other systemic therapy.
<strong>RESULTS:</strong> Three hundred six patients were registered; 286 are reported. Median time to progression was 24 months (95% CI, 18 to 39 months) in the standard therapy arm, and 35 months (95% CI, 26 to 44 months) in the chemohormonal group (P = .39). At median follow-up of 6.4 years, overall survival was 5.4 years (95% CI, 4.7 to 7.8 years) in the standard therapy arm versus 6.1 years (95% CI, 5.1 to 10.1 years; P = .41). Prostate-specific antigen kinetics at the time of androgen ablation and the nadir after hormone treatment were strongly correlated with survival. Chemotherapy significantly increased the burden of therapy, with 51% of patients experiencing an adverse event of grade 3 or worse, especially thromboembolic events.
<strong>CONCLUSION:</strong> There is no role for ketoconazole and doxorubicin alternating with vinblastine and estramustine before emergence of a castrate-resistant phenotype.</p>
</div></td></tr></table><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Jemal A, Siegel R, Ward E, et al: Cancer Statistics, 2007. CA Cancer J Clin 57:43-66, 2007</p>
</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/17237035/">https://pubmed.ncbi.nlm.nih.gov/17237035/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Yagoda A, Petrylak D: Cytotoxic chemotherapy for advanced hormone-resistant prostate cancer. Cancer 71:1098-1109, 1993</p>
</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/7679039/">https://pubmed.ncbi.nlm.nih.gov/7679039/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Beer T, Raghavan D: Chemotherapy for hormone-refractory prostate cancer: Beauty is in the eye of the beholder. Prostate 45:184-193, 2000</p>
</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/11027418/">https://pubmed.ncbi.nlm.nih.gov/11027418/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Ellerhorst JA, Tu SM, Amato RJ, et al: Phase II trial of alternating weekly chemohormonal therapy for patients with androgen-independent prostate cancer. Clin Cancer Res 3:2371-2376, 1997</p>
</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/9815636/">https://pubmed.ncbi.nlm.nih.gov/9815636/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Smith DC, Esper P, Strawderman M, et al: Phase II trial of oral estramustine, oral etoposide, and intravenous paclitaxel in hormone-refractory prostate cancer. J Clin Oncol 17:1664-1671, 1999</p>
</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/10561202/">https://pubmed.ncbi.nlm.nih.gov/10561202/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Kelly WK, Curley T, Slovin S, et al: Paclitaxel, estramustine phosphate, and carboplatin in patients with advanced prostate cancer. J Clin Oncol 19:44-53, 2001</p>
</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/11134194/">https://pubmed.ncbi.nlm.nih.gov/11134194/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Millikan RE, Thall PF, Lee SJ, et al: Randomized multicenter phase II trial of two multicomponent regimens in androgen independent prostate cancer. J Clin Oncol 21:878-883, 2003</p>
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</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/2213104/">https://pubmed.ncbi.nlm.nih.gov/2213104/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Pummer K, Lehnert M, Stettner H, et al: Randomized comparison of total androgen blockade alone versus combined with weekly epirubicin in advanced prostate cancer. Eur Urol 32:81-85, 1997. (suppl)</p>
</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/9267791/">https://pubmed.ncbi.nlm.nih.gov/9267791/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Janknegt RA, Boon TA, van de Beek C, et al: Combined hormono/chemotherapy as primary treatment for metastatic prostate cancer: A randomized, multicenter study of orchiectomy alone versus orchiectomy plus estramustine phosphate. Urology 49:411-420, 1997</p>
</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/9123707/">https://pubmed.ncbi.nlm.nih.gov/9123707/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Fontana D, Bertetto O, Fasolis G, et al: Randomized comparison of goserelin acetate versus mitomycin C plus goserelin acetate in previously untreated prostate cancer patients with bone metastases. Tumori 84:39-44, 1998</p>
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</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/11256836/">https://pubmed.ncbi.nlm.nih.gov/11256836/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Noguchi M, Noda Shinshi, Yoshida M, et al: Chemohormonal therapy as primary treatment for metastatic prostate cancer: A randomized study of estramustine phosphate plus luteinizing hormone-releasing hormone agonist versus flutamide plus luteinizing hormone-releasing hormone agonist. Int J Urol 11:103-109, 2004</p>
</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/14706014/">https://pubmed.ncbi.nlm.nih.gov/14706014/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>citation</b>: </p><div><p>Fisher LD, Belle GV: Biostatistics: A Methodology For the Health Sciences. New York, NY, John Wiley, 1993</p>
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</div></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>citation</b>: </p><div><p>Lawless JF: Statistical Models and Methods for Lifetime Data. New York, NY, John Wiley, 1982</p>
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</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/16921051/">https://pubmed.ncbi.nlm.nih.gov/16921051/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Stewart AJ, Scher HI, Chen M-H, et al: Prostate-specific antigen nadir and cancer-specific mortality following hormonal therapy for prostate-specific antigen failure. J Clin Oncol 23:6556-6560, 2005</p>
</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/16170163/">https://pubmed.ncbi.nlm.nih.gov/16170163/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Pettaway CA, Pisters LL, Troncoso P, et al: Neoadjuvant chemotherapy and hormonal therapy followed by radical prostatectomy: Feasibility and preliminary results. J Clin Oncol 18:1050-1057, 2000</p>
</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/10694556/">https://pubmed.ncbi.nlm.nih.gov/10694556/</a></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: Cites</p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>citation</b>: </p><div><p>Friedman J, Dunn RL, Wood D, et al: Neoadjuvant docetaxel and capecitabine in patients with high risk prostate cancer. J Urol 179:911-916, 2008</p>
</div><p><b>target</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/18207190/">https://pubmed.ncbi.nlm.nih.gov/18207190/</a></p></blockquote><blockquote><p><b>publicationForm</b></p><blockquote><p><b>publishedIn</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/published-in-type D020492}">Periodical</span></p><p><b>identifier</b>: Electronic ISSN Type/1527-7755, ISOAbbreviation/J Clin Oncol, ISSN Linking/0732-183X, Medline Title Abbreviation/J Clin Oncol, NLM Unique ID/8309333</p><p><b>title</b>: Journal of clinical oncology : official journal of the American Society of Clinical Oncology</p><p><b>publisherLocation</b>: United States</p></blockquote><p><b>citedMedium</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-medium internet}">Internet</span></p><p><b>volume</b>: 26</p><p><b>issue</b>: 36</p><p><b>articleDate</b>: 2008-12-20</p><p><b>pageString</b>: 5936-42</p></blockquote><blockquote><p><b>publicationForm</b></p><p><b>citedMedium</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-medium internet-without-issue}">Internet without issue</span></p><p><b>articleDate</b>: 2008-11-24</p></blockquote><blockquote><p><b>webLocation</b></p><p><b>classifier</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/artifact-url-classifier abstract}">Abstract</span></p><p><b>url</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/19029421/">https://pubmed.ncbi.nlm.nih.gov/19029421/</a></p></blockquote><blockquote><p><b>webLocation</b></p><p><b>classifier</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/artifact-url-classifier doi-based}">DOI Based</span></p><p><b>url</b>: <a href="https://doi.org/10.1200/JCO.2007.15.9830">https://doi.org/10.1200/JCO.2007.15.9830</a></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type publishing-model}">Publishing Model</span></p><p><b>classifier</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier Print-Electronic}">Print Electronic</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type chemical}">Chemical</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D000726}">Androgen Antagonists</span>, <span title="Codes:{https://www.nlm.nih.gov/mesh D000903}">Antibiotics, Antineoplastic</span>, <span title="Codes:{https://www.nlm.nih.gov/mesh D018906}">Antineoplastic Agents, Alkylating</span>, <span title="Codes:{https://www.nlm.nih.gov/mesh D000972}">Antineoplastic Agents, Phytogenic</span>, <span title="Codes:{https://www.cas.org/support/documentation/chemical-substances 35LT29625A}, {https://www.nlm.nih.gov/mesh D004961}">Estramustine</span>, <span title="Codes:{https://www.cas.org/support/documentation/chemical-substances 5V9KLZ54CY}, {https://www.nlm.nih.gov/mesh D014747}">Vinblastine</span>, <span title="Codes:{https://www.cas.org/support/documentation/chemical-substances 80168379AG}, {https://www.nlm.nih.gov/mesh D004317}">Doxorubicin</span>, <span title="Codes:{https://www.cas.org/support/documentation/chemical-substances R9400W927I}, {https://www.nlm.nih.gov/mesh D007654}">Ketoconazole</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">MeSH heading</span></p><p><b>artifactAssessment</b>: <a href="#hc179631/meshHeading0">ArtifactAssessment: artifact[x] = this resource</a></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type publication-type}">Publication type</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D017428}">Clinical Trial, Phase III</span>, <span title="Codes:{https://www.nlm.nih.gov/mesh D016428}">Journal Article</span>, <span title="Codes:{https://www.nlm.nih.gov/mesh D016449}">Randomized Controlled Trial</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type knowledge-artifact-type}">Knowledge Artifact Type</span></p><p><b>classifier</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>artifactAssessment</b>: Classifier added by Computable Publishing LLC</p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type citation-subset}">Citation subset</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#citationsubset IM}">IM</span></p></blockquote><blockquote><p><b>contributorship</b></p><p><b>complete</b>: true</p><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179631/contributor0">Millikan RE</a></p><p><b>forenameInitials</b>: RE</p><p><b>affiliation</b>: Department of Genitourinary Medical Oncology, University of Texas MD Anderson Cancer Center, 1155 Pressler, CPB7.3462, Houston, TX 77030, USA. rmillika@mdanderson.org</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179631/contributor1">Wen S</a></p><p><b>forenameInitials</b>: S</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179631/contributor2">Pagliaro LC</a></p><p><b>forenameInitials</b>: LC</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179631/contributor3">Brown MA</a></p><p><b>forenameInitials</b>: MA</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179631/contributor4">Moomey B</a></p><p><b>forenameInitials</b>: B</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179631/contributor5">Do KA</a></p><p><b>forenameInitials</b>: KA</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179631/contributor6">Logothetis CJ</a></p><p><b>forenameInitials</b>: CJ</p></blockquote></blockquote></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner #contributor0</b></p><a name="179631/contributor0"> </a><a name="hc179631/contributor0"> </a><p><b>name</b>: Randall E Millikan </p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner #contributor1</b></p><a name="179631/contributor1"> </a><a name="hc179631/contributor1"> </a><p><b>name</b>: Sijin Wen </p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner #contributor2</b></p><a name="179631/contributor2"> </a><a name="hc179631/contributor2"> </a><p><b>name</b>: Lance C Pagliaro </p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner #contributor3</b></p><a name="179631/contributor3"> </a><a name="hc179631/contributor3"> </a><p><b>name</b>: Melissa A Brown </p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner #contributor4</b></p><a name="179631/contributor4"> </a><a name="hc179631/contributor4"> </a><p><b>name</b>: Brenda Moomey </p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner #contributor5</b></p><a name="179631/contributor5"> </a><a name="hc179631/contributor5"> </a><p><b>name</b>: Kim-Anh Do </p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner #contributor6</b></p><a name="179631/contributor6"> </a><a name="hc179631/contributor6"> </a><p><b>name</b>: Christopher J Logothetis </p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: ArtifactAssessment #meshHeading0</b></p><a name="179631/meshHeading0"> </a><a name="hc179631/meshHeading0"> </a><p><b>artifact</b>: <a href="#hc179631">Citation 19029421 Phase III trial of androgen ablation with or without three cycles of systemic chemotherapy for advanced prostate cancer.</a></p><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D000328}">Adult</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D000368}">Aged</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D000369}">Aged, 80 and over</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D000726}">Androgen Antagonists</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000627}">therapeutic use</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49488}">Yes</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D000903}">Antibiotics, Antineoplastic</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000008}">administration &amp; dosage</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49487}">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D018906}">Antineoplastic Agents, Alkylating</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000008}">administration &amp; dosage</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49487}">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D000972}">Antineoplastic Agents, Phytogenic</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000008}">administration &amp; dosage</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49487}">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D000971}">Antineoplastic Combined Chemotherapy Protocols</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000627}">therapeutic use</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49488}">Yes</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D004317}">Doxorubicin</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000008}">administration &amp; dosage</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49487}">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D004961}">Estramustine</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000008}">administration &amp; dosage</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49487}">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D006801}">Humans</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D007654}">Ketoconazole</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000008}">administration &amp; dosage</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49487}">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D008297}">Male</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span 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**PATIENTS AND METHODS:** Eligible patients had metastatic prostate cancer threatening enough to justify sustained androgen ablation and were fit enough for chemotherapy. The primary end point was time to castrate-resistant progression as shown by increasing prostate-specific antigen, new radiographic lesions, worsening cancer-related symptoms, or receipt of any other systemic therapy.
**RESULTS:** Three hundred six patients were registered; 286 are reported. Median time to progression was 24 months (95% CI, 18 to 39 months) in the standard therapy arm, and 35 months (95% CI, 26 to 44 months) in the chemohormonal group (P = .39). At median follow-up of 6.4 years, overall survival was 5.4 years (95% CI, 4.7 to 7.8 years) in the standard therapy arm versus 6.1 years (95% CI, 5.1 to 10.1 years; P = .41). Prostate-specific antigen kinetics at the time of androgen ablation and the nadir after hormone treatment were strongly correlated with survival. Chemotherapy significantly increased the burden of therapy, with 51% of patients experiencing an adverse event of grade 3 or worse, especially thromboembolic events.
**CONCLUSION:** There is no role for ketoconazole and doxorubicin alternating with vinblastine and estramustine before emergence of a castrate-resistant phenotype."/>
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