Risk stratification of metastatic disease burden in hormone naive metastatic prostate cancer -The STAMPEDE analysis

Abstract

Introduction Docetaxel or abiraterone in addition to androgen deprivation therapy have been shown to deliver survival benefit in the treatment of metastatic hormone naive prostate cancer. However, a body of evidence supporting a limited docetaxel treatment benefit in the subgroup of men with low disease burden has generating clinical confusion. The work within this thesis retrospectively analysed baseline imaging from the published Stampede trial dataset to assess the treatment benefit within metastatic burden defined subgroups. Method 1207 metastatic patients were identified from the docetaxel and control containing arms of the Stampede trial and a further 753 patients have been identified within the abiraterone containing arm. Imaging was retrospectively transferred by means of a novel digital imaging transfer platform. Patients were stratified according to the Chaarted and Latitude volume/risk criteria. Exploratory burden analysis critiqued these existing definitions. Results A clear survival benefit from docetaxel was observed in the high-volume subgroup (HR: 0.73, 95% CI [0.55-0.98], p

Date of Award	1 Aug 2019
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Michael Brown (Supervisor) & Noel Clarke (Supervisor)