Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy

NCT ID: NCT00268476

Last Updated: 2023-04-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

11992 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-07-08

Study Completion Date

2030-12-31

Brief Summary

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The overall aim of this trial, which is called STAMPEDE, is to assess novel approaches for the treatment of men with prostate cancer who are starting long-term ADT for the first time, termed hormone-naïve prostate cancer. This trial aims to see if we can improve the way in which prostate cancer is currently managed, either by adding new treatments to the standard approach or by modifying the type of hormone therapy aiming to improve quality-of-life by reducing the side effects of treatment. Each new treatment approach is compared against a control arm receiving the current standard treatments. We aim to identify treatment strategies that enable men to live longer, or as long but with an improved quality-of-life, as well as offering value for money for the health service.

Since opening to accrual in Oct-2005, the trial has tested many ways of treating prostate cancer and some results are now already known. More than 10,000 men will join the trial with answers becoming available throughout the trial. New patients joining the trial from Protocol version 17.0 onwards (activated in December 2018) may be eligible to join one of two treatment comparisons, metformin (treatment group K; the "metformin comparison") and transdermal oestradiol (treatment group L; the "transdermal oestradiol comparison"). A computer program will be used to allocate which treatment each participant receives, using a chance process.

Summary of the research arms in STAMPEDE trial platform Summary of research treatment groups currently open to recruitment (June 2017)

1. Metformin (Arm K): This anti-diabetic medication is proposed to have both anti-cancer effects and may help prevent the adverse metabolic effects of long-term ADT. STAMPEDE will investigate whether adding metformin to the current standard-of-care for non-diabetic men can improve all-cause survival.
2. Transdermal oestradiol (Arm L): This is an alternative form of hormone treatment which has been shown to suppress testosterone as effectively as standard ADT and avoid some of the side-effects. It may also help to avoid the adverse metabolic effects and fatigue and therefore improve overall quality of life compared with standard forms of ADT. STAMPEDE will investigate whether transdermal oestradiol can treat the cancer as well as current standard forms of ADT.
3. Control group (Arm A): Patients allocated to this group receive the current standard-of-care ADT +/- RT +/- docetaxel.

Detailed Description

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STAMPEDE (also known as MRC PR08) is a multi-arm multi-stage (MAMS) randomised controlled trial recruiting in the UK and Switzerland. It aims to evaluate multiple therapeutic strategies in the management of high-risk locally advanced and metastatic hormone-naïve prostate cancer. Each novel treatment strategy is compared against a single, contemporaneous control arm. When the trial originally opened in 2005 there were 6 research arms enabling 5 randomised comparisons. Each comparison is evaluated in stages with pre-planned interim analyses after which recruitment may be halted should the experimental treatment fail to reach a "hurdle" of activity. Patient data from all arms and all stages are, however, included in the final analyses of the primary outcome measure, even if the investigational arm did not proceed to the final stage.

Providing sufficient activity is demonstrated, recruitment continues to the final stage and then an assessment of efficacy is determined based on the primary outcome of overall survival. Patient data from all arms and all stages are included in the final analyses of the primary outcome measure, even if the investigational arm did not proceed to the final stage.

The original comparisons which have all now been reported, evaluated a bisphosphonate (zoledronic acid), a cytotoxic chemotherapeutic agent (docetaxel) and a cyclooxygenase (Cox 2) inhibitor (celecoxib), as single agents or combinations. Since the start of the trial, a number of new research arms have been added to STAMPEDE over time to evaluate: abiraterone, a steroid synthesis inhibitor; prostate radiotherapy for patients with newly diagnosed metastatic disease; enzalutamide, an inhibitor of androgen receptor signalling, given with abiraterone; and metformin, an anti-diabetic medication and transdermal oestradiol, to be given as an alternative form of ADT.

Objectives:

Primary

To compare the safety and efficacy of novel therapeutic strategies against the current standard-of-care for men with high-risk locally advanced or metastatic prostate cancer starting long-term ADT for the first time.

Outline: This is a randomised, controlled, multi-centre MAMS trial platform. Patients are current randomised to 1 of 3 arms: control group (arm A), metformin treatment group (arm K) and transdermal oestradiol (Arm L). The other arms are all closed to recruitment with results known for all the original comparisons and awaited for others added since the trial commenced.

Patient population: STAMPEDE recruits both men with high-risk locally advanced prostate cancer and men with metastatic prostate cancer, all of whom must be starting long-term ADT for the first time. Patients who received previous radical treatment and are now relapsing with high-risk features are also eligible.

Follow-up: All patients are follow-up life long

Sub-studies: There are several translational sub-studies ongoing as part of STAMPEDE. Participation is optional. These currently include several translational sub-studies involving sample collection: saliva collection for germline DNA analysis, sequential circulating tumour DNA analysis and FFPE tumour block retrieval for DNA and RNA analysis. Other sub-studies include a QOL sub-study and an imaging sub-study.

Conditions

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Prostate Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Multi-arm Multi-Stage
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm A: Standard of Care

Androgen Deprivation Therapy \[ADT\] (plus Radiotherapy for newly-diagnosed non-metastatic disease, plus or minus Docetaxel, plus or minus Abiraterone)\[Control\]

Group Type ACTIVE_COMPARATOR

ADT

Intervention Type DRUG

Arm B: Zoledronic Acid

(ADT + zoledronic acid) NO LONGER RECRUITING

Group Type EXPERIMENTAL

ADT

Intervention Type DRUG

Zoledronic Acid

Intervention Type DRUG

Arm C: Docetaxel

(ADT + docetaxel + prednisolone) NO LONGER RECRUITING

Group Type EXPERIMENTAL

Docetaxel

Intervention Type DRUG

Prednisolone

Intervention Type DRUG

ADT

Intervention Type DRUG

Arm D: Celecoxib

(ADT + celecoxib) NO LONGER RECRUITING

Group Type EXPERIMENTAL

Celecoxib

Intervention Type DRUG

ADT

Intervention Type DRUG

Arm E: Zoledronic Acid & Docetaxel

(ADT + zoledronic acid + docetaxel + prednisolone) NO LONGER RECRUITING

Group Type EXPERIMENTAL

Docetaxel

Intervention Type DRUG

Prednisolone

Intervention Type DRUG

ADT

Intervention Type DRUG

Zoledronic Acid

Intervention Type DRUG

Arm F: Zoledronic Acid & Celecoxib

(ADT + zoledronic acid + celecoxib) NO LONGER RECRUITING

Group Type EXPERIMENTAL

Celecoxib

Intervention Type DRUG

ADT

Intervention Type DRUG

Zoledronic Acid

Intervention Type DRUG

Arm G: Abiraterone

(ADT + abiraterone acetate + prednisolone) NO LONGER RECRUITING

Group Type EXPERIMENTAL

Prednisolone

Intervention Type DRUG

ADT

Intervention Type DRUG

Abiraterone

Intervention Type DRUG

Arm H: M1 RT

(ADT + radiotherapy to the prostate) NO LONGER RECRUITING

Group Type EXPERIMENTAL

ADT

Intervention Type DRUG

Radiotherapy to the prostate

Intervention Type RADIATION

Arm J: Abiraterone * Enzalutamide

(ADT + abiraterone + enzalutamide + Prednisolone) NO LONGER RECRUITING

Group Type EXPERIMENTAL

Prednisolone

Intervention Type DRUG

ADT

Intervention Type DRUG

Abiraterone

Intervention Type DRUG

Enzalutamide

Intervention Type DRUG

Arm K: Metformin

(ADT + Metformin) RECRUITING IN SELECTED SITES

Group Type EXPERIMENTAL

ADT

Intervention Type DRUG

Metformin

Intervention Type DRUG

Arm L: tE2

(Transdermal oestradiol) RECRUITING

Group Type EXPERIMENTAL

Transdermal Oestradiol

Intervention Type DRUG

Interventions

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Celecoxib

Intervention Type DRUG

Docetaxel

Intervention Type DRUG

Prednisolone

Intervention Type DRUG

ADT

Intervention Type DRUG

Zoledronic Acid

Intervention Type DRUG

Abiraterone

Intervention Type DRUG

Radiotherapy to the prostate

Intervention Type RADIATION

Enzalutamide

Intervention Type DRUG

Metformin

Intervention Type DRUG

Transdermal Oestradiol

Intervention Type DRUG

Other Intervention Names

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Celebrex Taxotere Prednisone Androgen Deprivation Therapy Zometa Zytiga RT Xtandi Metformin Hydrochloride Progynova TS

Eligibility Criteria

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Inclusion Criteria

1. High-Risk Newly-Diagnosed Non-Metastatic Node-Negative (N0/Nx) Disease

Both:

• At least two of: T category T3/4, PSA≥40ng/ml or Gleason sum score 8-10

• Intention to treat with radical radiotherapy (unless there is a contra-indication)

OR
2. Newly-Diagnosed Metastatic Or Node-Positive Disease

At least one of:
* Stage Tany N+ M0
* Stage Tany Nany M+

OR
3. Previously Radically Treated, Now Relapsing (Prior Radical Surgery And/or Radiotherapy)

At least one of:

• PSA ≥4ng/ml and rising with doubling time less than 6 months

• PSA ≥20ng/ml

• N+

• M+

AND

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1. Histologically confirmed prostate adenocarcinoma
2. Intention to treat with long-term androgen deprivation therapy
3. Fit for all protocol treatment and follow up, WHO performance status 0-2
4. Have completed the appropriate investigations prior to randomisation
5. Adequate haematological function: neutrophil count ≥1.5x109/l and platelets ≥100x109/l
6. Adequate renal function, defined as GFR ≥30ml/min/1.73m2
7. Written informed consent
8. Willing and expected to comply with follow up schedule
9. Using effective contraceptive method if applicable

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1. Medical contraindications to the trial medications are given in Section 6
2. For WHO performance status definitions see Appendix A


• HbA1c \<48mmol/mol (equivalent to \<6.5%) (1)

• Adequate renal function, defined as GFR ≥45ml/min/1.73m (except for Switzerland (2))

• No history of lactic acidosis or pre-disposing conditions

* Not current or previous treatment with metformin
* No contra-indications to metformin
* No current or previous medication for treatment of diabetes
* Willingness to join the metabolic sub study

The method used to determine glomerular filtration rate may vary according to local practice.

Equations that either estimate glomerular filtration rate (eGFR) or creatinine clearance (CrCl) may be used and the same threshold value applies. Where possible, HbA1c should be performed prior to commencing SOC docetaxel to reduce the likelihood of corticosteroid-related hyperglycaemia impacting on eligibility. All participants with abnormal baseline HbA1c (i.e. 6.5% or higher) should be informed and referred to their GP for further management.

(2) Except Switzerland, please refer to SAKK appendix for local guidance

For Randomisation To The "Transdermal Oestradiol Comparison"

Exclusion Criteria

Patients must not fulfil any of the criteria below:

1. Prior systemic therapy for locally-advanced or metastatic prostate cancer (1) (except as listed in the protocol section 4.3)
2. Prior exposure to hormone therapy for a duration of \> 12 months, or prior exposure completing \< 12 months before randomisation (see section 4.3.1 for permitted prior exposure details)
3. Metastatic brain disease or leptomeningeal disease
4. Abnormal liver functions consisting of any of the following:

• Serum bilirubin ≥1.5 x ULN (except for patients with Gilbert's disease, for whom the upper limit of serum bilirubin is 51.3μmol/l or 3mg/dl)

• Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≥2.5 x ULN - site must indicate at randomisation whether one or both tests are performed at site. Where both results are available both must confirm eligibility.
5. Any other previous or current malignant disease which, in the judgement of the responsible clinician, is likely to interfere with STAMPEDE treatment or assessment
6. Any surgical wound (e.g. TURP) which in the judgement of the responsible clinician may interfere with or be exacerbated by protocol treatment
7. Participant with significant cardiovascular disease, including:

• Severe/unstable angina

• Myocardial infarction less than 6 months prior to randomisation

• Arterial thrombotic events less than 6 months prior to randomisation

• Clinically significant cardiac failure requiring treatment, defined as New York Heart Association (NYHA) class II or above (1)

• Cerebrovascular disease (e.g. stroke or transient ischaemic episode) less than 6 months prior to randomisation
* Any other significant cardiovascular disease that in the investigator's opinion means the participant is unfit for any of the study treatments.

1. Excluding participants receiving docetaxel as part of SOC
2. NYHA classifications can be found in Appendix A

6\. Comparison-specific eligibility criteria


For Randomisation to the "Metformin Comparison"

Please note from protocol v20 only patients willing to participate in the metabolic sub study should be randomised to the metformin comparison. The sub study will be conducted in a limited number of sites, see section 4.7.4 for further information.


• ≤8 weeks of anti-androgen (AR-antagonists) use

• Maximum of 1 dose of monthly or 4-weekly LHRH agonist/antagonist

• No prior LHRH agonist injection with a stated duration of effect greater than 1 month

• ≤12 weeks since first dose of any hormone therapy

• Not had a bilateral orchidectomy

• No use of cyproterone acetate (36) prior to randomisation

• No known porphyria

* No known history of deep vein thrombosis or pulmonary embolism confirmed radiologically
* No known thrombophilic disorder (e.g. Protein C, Protein S, antithrombin deficiency)
* Not yet started SOC abiraterone, enzalutamide or apalutamide
Maximum Eligible Age

120 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Medical Research Council

OTHER_GOV

Sponsor Role lead

Responsible Party

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Medical Research Council

Medical Research Council

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Nicholas D. James, MD

Role: STUDY_CHAIR

Institute of Cancer Research, United Kingdom

Locations

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Lausanne Centre Hospitalier Universitaire

Lausanne, Canton of Vaud, Switzerland

Site Status

Winterthur Hospital

Winterthur, Canton of Zurich, Switzerland

Site Status

Kantonsspital Graubuenden

Chur, Kanton Graubünden, Switzerland

Site Status

Hirslanden Klinik Aarau

Aarau, , Switzerland

Site Status

Universitaetsspital-Basel

Basel, , Switzerland

Site Status

Inselspital Bern

Bern, , Switzerland

Site Status

Liestal Hospital

Liestal, , Switzerland

Site Status

Kantonsspital - St. Gallen

Sankt Gallen, , Switzerland

Site Status

UniversitaetsSpital Zuerich

Zurich, , Switzerland

Site Status

City Hospital Triemli

Zurich, , Switzerland

Site Status

Berkshire Cancer Centre at Royal Berkshire Hospital

Reading, Berkshire, United Kingdom

Site Status

Royal Bolton Hospital

Farnworth, Bolton, United Kingdom

Site Status

Wycombe General Hospital

High Wycombe, Buckinghamshire, United Kingdom

Site Status

Addenbrooke's Hospital

Cambridge, Cambridgeshire, United Kingdom

Site Status

Broomfield Hospital

Broomfield, Chelmsford, United Kingdom

Site Status

Countess of Chester Hospital

Chester, Chesire, United Kingdom

Site Status

James Cook University Hospital

Middlesbrough, County Durham, United Kingdom

Site Status

Cumberland Infirmary

Carlisle, Cumbria, United Kingdom

Site Status

North Devon District Hospital

Barnstaple, Devon, United Kingdom

Site Status

Royal Devon and Exeter Hospital

Exeter, Devon, United Kingdom

Site Status

Royal Bournemouth Hospital

Bournemouth, Dorset, United Kingdom

Site Status

Dorset County Hospital

Dorchester, Dorset, United Kingdom

Site Status

Poole Hospital

Poole, Dorset, United Kingdom

Site Status

Castle Hill Hospital

Cottingham, East Riding Of Yorkshire, United Kingdom

Site Status

Eastbourne District General Hospital

Eastbourne, East Sussex, United Kingdom

Site Status

Conquest Hospital

Saint Leonards-on-Sea, East Sussex, United Kingdom

Site Status

William Harvey Hospital

Ashford, England, United Kingdom

Site Status

Stoke Mandeville Hospital

Aylesbury, England, United Kingdom

Site Status

Basingstoke and North Hampshire NHS Foundation Trust

Basingstoke, England, United Kingdom

Site Status

City Hospital (Birmingham)

Birmingham, England, United Kingdom

Site Status

Sussex Cancer Centre at Royal Sussex County Hospital

Brighton, England, United Kingdom

Site Status

Burnley General Hospital

Burnley, England, United Kingdom

Site Status

Queen's Hospital

Burton-on-Trent, England, United Kingdom

Site Status

West Suffolk Hospital

Bury St Edmunds, England, United Kingdom

Site Status

Mid Cheshire Hospitals Trust- Leighton Hopsital

Crewe, England, United Kingdom

Site Status

Darlington Memorial

Darlington, England, United Kingdom

Site Status

Derbyshire Royal Infirmary

Derby, England, United Kingdom

Site Status

Doncaster Royal Infirmary

Doncaster, England, United Kingdom

Site Status

Russells Hall Hospital

Dudley, England, United Kingdom

Site Status

University Hospital of North Durham

Durham, England, United Kingdom

Site Status

Gloucestershire Royal Hospital

Gloucester, England, United Kingdom

Site Status

Hereford County Hospital

Hereford, England, United Kingdom

Site Status

Kidderminster Hospital

Kidderminster, England, United Kingdom

Site Status

Leeds Cancer Centre at St. James's University Hospital

Leeds, England, United Kingdom

Site Status

Glenfield Hospital

Leicester, England, United Kingdom

Site Status

Royal Liverpool University Hospital

Liverpool, England, United Kingdom

Site Status

University Hospital Aintree

Liverpool, England, United Kingdom

Site Status

Helen Rollason Cancer Care Centre at North Middlesex Hospital

London, England, United Kingdom

Site Status

Guy's Hospital

London, England, United Kingdom

Site Status

St. Mary's Hospital

London, England, United Kingdom

Site Status

UCL Cancer Institute

London, England, United Kingdom

Site Status

University College of London Hospitals

London, England, United Kingdom

Site Status

Withington Hospital

Manchester, England, United Kingdom

Site Status

Royal Shrewsbury Hospital

Shrewsbury, England, United Kingdom

Site Status

Stepping Hill Hospital

Stockport, England, United Kingdom

Site Status

Sunderland Royal Hospital

Sunderland, England, United Kingdom

Site Status

Torbay Hospital

Torquay, England, United Kingdom

Site Status

Warrington Hospital NHS Trust

Warrington, England, United Kingdom

Site Status

West Cumberland Hospital

Whitehaven, England, United Kingdom

Site Status

Royal Albert Edward Infirmary

Wigan, England, United Kingdom

Site Status

Worcester Royal Hospital

Worcester, England, United Kingdom

Site Status

Worthing Hospital

Worthing, England, United Kingdom

Site Status

Princess Alexandra Hospital

Harlow, Essex, United Kingdom

Site Status

Queen's Hospital

Romford, Essex, United Kingdom

Site Status

Southend University Hospital NHS Foundation Trust

Westcliff-on-Sea, Essex, United Kingdom

Site Status

South West Wales Cancer Institute At Singleton Hospital

Swansea, Glamorgan, United Kingdom

Site Status

Cheltenham General Hospital

Cheltenham, Gloucestershire, United Kingdom

Site Status

St. Bartholomews Hospital

London, Greater London, United Kingdom

Site Status

Queen Elizabeth Hospital - Woolwich

London, Greater London, United Kingdom

Site Status

St. George's Hospital

London, Greater London, United Kingdom

Site Status

Charing Cross Hospital

London, Greater London, United Kingdom

Site Status

Christie Hospital

Manchester, Greater Manchester, United Kingdom

Site Status

Royal Oldham Hospital

Oldham, Greater Manchester, United Kingdom

Site Status

Southampton General Hospital

Southampton, Hampshire, United Kingdom

Site Status

Lister Hospital

Stevenage, Hertfordshire, United Kingdom

Site Status

Raigmore Hospital

Inverness, Highland, United Kingdom

Site Status

St. Mary's Hospital

Newport, Isle Of Wight, United Kingdom

Site Status

Airedale General Hospital

Steeton, Keighley, United Kingdom

Site Status

Kent and Canterbury Hospital

Canterbury, Kent, United Kingdom

Site Status

Mid Kent Oncology Centre at Maidstone Hospital

Maidstone, Kent, United Kingdom

Site Status

Queen Elizabeth The Queen Mother Hospital

Margate, Kent, United Kingdom

Site Status

Beatson Institute for Cancer Research - Glasgow

Glasgow, Lanarkshire, United Kingdom

Site Status

Rosemere Cancer Centre at Royal Preston Hospital

Preston, Lancashire, United Kingdom

Site Status

Southport and Formby District General Hospital

Southport, Merseyside, United Kingdom

Site Status

Mount Vernon Cancer Centre at Mount Vernon Hospital

Northwood, Middlesex, United Kingdom

Site Status

Edinburgh Cancer Centre at Western General Hospital

Edinburgh, Midlothian, United Kingdom

Site Status

Freeman Hospital

Newcastle, Newcastle-upon-Tyne, United Kingdom

Site Status

Scarborough General Hospital

Scarborough, North Yorkshire, United Kingdom

Site Status

Centre for Cancer Research and Cell Biology at Queen's University Belfast

Belfast, Northern Ireland, United Kingdom

Site Status

Nottingham City Hospital

Nottingham, Nottinghamshire, United Kingdom

Site Status

King's Mill Hospital

Sutton in Ashfield, Nottinghamshire, United Kingdom

Site Status

Churchill Hospital

Oxford, Oxfordshire, United Kingdom

Site Status

Queen Alexandra Hospital

Cosham, Portsmouth, United Kingdom

Site Status

Ayr Hospital

Ayr, Scotland, United Kingdom

Site Status

Royal United Hospital

Bath, Somerset, United Kingdom

Site Status

Bristol Haematology and Oncology Centre

Bristol, Somerset, United Kingdom

Site Status

Musgrove Park Hospital

Taunton, Somerset, United Kingdom

Site Status

Weston General Hospital

Weston-super-Mare, Somerset, United Kingdom

Site Status

Yeovil District Hospital

Yeovil, Somerset, United Kingdom

Site Status

Cancer Research Centre at Weston Park Hospital

Sheffield, South Yorkshire, United Kingdom

Site Status

Royal Stoke University Hospital

Stoke-on-Trent, Staffordshire, United Kingdom

Site Status

Ipswich Hospital

Ipswich, Suffolk, United Kingdom

Site Status

St. Luke's Cancer Centre at Royal Surrey County Hospital

Guildford, Surrey, United Kingdom

Site Status

Royal Marsden - Sutton

Sutton, Surrey, United Kingdom

Site Status

Northern Centre for Cancer Treatment at Newcastle General Hospital

Newcastle upon Tyne, Tyne & Wear, United Kingdom

Site Status

South Tyneside District Hospital

South Shields, Tyne & Wear, United Kingdom

Site Status

Bronglais General Hospital

Aberystwyth, Wales, United Kingdom

Site Status

Velindre Cancer Center at Velindre Hospital

Cardiff, Wales, United Kingdom

Site Status

Queen Elizabeth Hospital at University Hospital of Birmingham NHS Trust

Birmingham, West Midlands, United Kingdom

Site Status

Good Hope Hospital

Sutton Coldfield, West Midlands, United Kingdom

Site Status

Bradford Royal Infirmary

Bradford, West Yorkshire, United Kingdom

Site Status

Huddersfield Royal Infirmary

Huddersfield, West Yorkshire, United Kingdom

Site Status

Great Western Hospital

Swindon, Wiltshire, United Kingdom

Site Status

Clatterbridge Centre for Oncology

Bebington, Wirral, United Kingdom

Site Status

Barnet General Hospital

Barnet, , United Kingdom

Site Status

Colchester General Hospital

Colchester, , United Kingdom

Site Status

Forth Valley Hospital

Larbert, , United Kingdom

Site Status

Lincoln Hospital

Lincoln, , United Kingdom

Site Status

North Tees Hospital

Stockton-on-Tees, , United Kingdom

Site Status

New Cross Hospital

Wolverhampton, , United Kingdom

Site Status

Countries

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Switzerland United Kingdom

References

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Sydes MR, Parmar MK, James ND, Clarke NW, Dearnaley DP, Mason MD, Morgan RC, Sanders K, Royston P. Issues in applying multi-arm multi-stage methodology to a clinical trial in prostate cancer: the MRC STAMPEDE trial. Trials. 2009 Jun 11;10:39. doi: 10.1186/1745-6215-10-39.

Reference Type BACKGROUND
PMID: 19519885 (View on PubMed)

Sydes MR, Parmar MK, Mason MD, Clarke NW, Amos C, Anderson J, de Bono J, Dearnaley DP, Dwyer J, Green C, Jovic G, Ritchie AW, Russell JM, Sanders K, Thalmann G, James ND. Flexible trial design in practice - stopping arms for lack-of-benefit and adding research arms mid-trial in STAMPEDE: a multi-arm multi-stage randomized controlled trial. Trials. 2012 Sep 15;13:168. doi: 10.1186/1745-6215-13-168.

Reference Type BACKGROUND
PMID: 22978443 (View on PubMed)

Parker CC, Sydes MR, Mason MD, Clarke NW, Aebersold D, de Bono JS, Dearnaley DP, Ritchie AW, Russell JM, Thalmann G, Parmar MK, James ND. Prostate radiotherapy for men with metastatic disease: a new comparison in the Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy (STAMPEDE) trial. BJU Int. 2013 May;111(5):697-9. doi: 10.1111/bju.12087. No abstract available.

Reference Type BACKGROUND
PMID: 23578233 (View on PubMed)

Attard G, Sydes MR, Mason MD, Clarke NW, Aebersold D, de Bono JS, Dearnaley DP, Parker CC, Ritchie AW, Russell JM, Thalmann G, Cassoly E, Millman R, Matheson D, Schiavone F, Spears MR, Parmar MK, James ND. Combining enzalutamide with abiraterone, prednisone, and androgen deprivation therapy in the STAMPEDE trial. Eur Urol. 2014 Nov;66(5):799-802. doi: 10.1016/j.eururo.2014.05.038. Epub 2014 Jun 27.

Reference Type BACKGROUND
PMID: 24985962 (View on PubMed)

James ND, Spears MR, Clarke NW, Dearnaley DP, De Bono JS, Gale J, Hetherington J, Hoskin PJ, Jones RJ, Laing R, Lester JF, McLaren D, Parker CC, Parmar MKB, Ritchie AWS, Russell JM, Strebel RT, Thalmann GN, Mason MD, Sydes MR. Survival with Newly Diagnosed Metastatic Prostate Cancer in the "Docetaxel Era": Data from 917 Patients in the Control Arm of the STAMPEDE Trial (MRC PR08, CRUK/06/019). Eur Urol. 2015 Jun;67(6):1028-1038. doi: 10.1016/j.eururo.2014.09.032. Epub 2014 Oct 6.

Reference Type BACKGROUND
PMID: 25301760 (View on PubMed)

James ND, Spears MR, Clarke NW, Dearnaley DP, Mason MD, Parker CC, Ritchie AW, Russell JM, Schiavone F, Attard G, de Bono JS, Birtle A, Engeler DS, Elliott T, Matheson D, O'Sullivan J, Pudney D, Srihari N, Wallace J, Barber J, Syndikus I, Parmar MK, Sydes MR; STAMPEDE Investigators. Failure-Free Survival and Radiotherapy in Patients With Newly Diagnosed Nonmetastatic Prostate Cancer: Data From Patients in the Control Arm of the STAMPEDE Trial. JAMA Oncol. 2016 Mar;2(3):348-57. doi: 10.1001/jamaoncol.2015.4350.

Reference Type BACKGROUND
PMID: 26606329 (View on PubMed)

Gillessen S, Gilson C, James N, Adler A, Sydes MR, Clarke N; STAMPEDE Trial Management Group. Repurposing Metformin as Therapy for Prostate Cancer within the STAMPEDE Trial Platform. Eur Urol. 2016 Dec;70(6):906-908. doi: 10.1016/j.eururo.2016.07.015. Epub 2016 Jul 19.

Reference Type BACKGROUND
PMID: 27450106 (View on PubMed)

Gilbert DC, Duong T, Sydes M, Bara A, Clarke N, Abel P, James N, Langley R, Parmar M; STAMPEDE and PATCH Trial Management Groups. Transdermal oestradiol as a method of androgen suppression for prostate cancer within the STAMPEDE trial platform. BJU Int. 2018 May;121(5):680-683. doi: 10.1111/bju.14153. Epub 2018 Feb 28. No abstract available.

Reference Type BACKGROUND
PMID: 29388336 (View on PubMed)

Parmar MK, Barthel FM, Sydes M, Langley R, Kaplan R, Eisenhauer E, Brady M, James N, Bookman MA, Swart AM, Qian W, Royston P. Speeding up the evaluation of new agents in cancer. J Natl Cancer Inst. 2008 Sep 3;100(17):1204-14. doi: 10.1093/jnci/djn267. Epub 2008 Aug 26.

Reference Type BACKGROUND
PMID: 18728279 (View on PubMed)

James ND, Sydes MR, Clarke NW, Mason MD, Dearnaley DP, Anderson J, Popert RJ, Sanders K, Morgan RC, Stansfeld J, Dwyer J, Masters J, Parmar MK. Systemic therapy for advancing or metastatic prostate cancer (STAMPEDE): a multi-arm, multistage randomized controlled trial. BJU Int. 2009 Feb;103(4):464-9. doi: 10.1111/j.1464-410X.2008.08034.x. Epub 2008 Oct 8.

Reference Type RESULT
PMID: 18990168 (View on PubMed)

James ND, Sydes MR, Mason MD, Clarke NW, Anderson J, Dearnaley DP, Dwyer J, Jovic G, Ritchie AW, Russell JM, Sanders K, Thalmann GN, Bertelli G, Birtle AJ, O'Sullivan JM, Protheroe A, Sheehan D, Srihari N, Parmar MK; STAMPEDE investigators. Celecoxib plus hormone therapy versus hormone therapy alone for hormone-sensitive prostate cancer: first results from the STAMPEDE multiarm, multistage, randomised controlled trial. Lancet Oncol. 2012 May;13(5):549-58. doi: 10.1016/S1470-2045(12)70088-8. Epub 2012 Mar 26.

Reference Type RESULT
PMID: 22452894 (View on PubMed)

Vale CL, Burdett S, Rydzewska LHM, Albiges L, Clarke NW, Fisher D, Fizazi K, Gravis G, James ND, Mason MD, Parmar MKB, Sweeney CJ, Sydes MR, Tombal B, Tierney JF; STOpCaP Steering Group. Addition of docetaxel or bisphosphonates to standard of care in men with localised or metastatic, hormone-sensitive prostate cancer: a systematic review and meta-analyses of aggregate data. Lancet Oncol. 2016 Feb;17(2):243-256. doi: 10.1016/S1470-2045(15)00489-1. Epub 2015 Dec 21.

Reference Type RESULT
PMID: 26718929 (View on PubMed)

Mason MD, Clarke NW, James ND, Dearnaley DP, Spears MR, Ritchie AWS, Attard G, Cross W, Jones RJ, Parker CC, Russell JM, Thalmann GN, Schiavone F, Cassoly E, Matheson D, Millman R, Rentsch CA, Barber J, Gilson C, Ibrahim A, Logue J, Lydon A, Nikapota AD, O'Sullivan JM, Porfiri E, Protheroe A, Srihari NN, Tsang D, Wagstaff J, Wallace J, Walmsley C, Parmar MKB, Sydes MR; STAMPEDE Investigators. Adding Celecoxib With or Without Zoledronic Acid for Hormone-Naive Prostate Cancer: Long-Term Survival Results From an Adaptive, Multiarm, Multistage, Platform, Randomized Controlled Trial. J Clin Oncol. 2017 May 10;35(14):1530-1541. doi: 10.1200/JCO.2016.69.0677. Epub 2017 Mar 13.

Reference Type RESULT
PMID: 28300506 (View on PubMed)

James ND, de Bono JS, Spears MR, Clarke NW, Mason MD, Dearnaley DP, Ritchie AWS, Amos CL, Gilson C, Jones RJ, Matheson D, Millman R, Attard G, Chowdhury S, Cross WR, Gillessen S, Parker CC, Russell JM, Berthold DR, Brawley C, Adab F, Aung S, Birtle AJ, Bowen J, Brock S, Chakraborti P, Ferguson C, Gale J, Gray E, Hingorani M, Hoskin PJ, Lester JF, Malik ZI, McKinna F, McPhail N, Money-Kyrle J, O'Sullivan J, Parikh O, Protheroe A, Robinson A, Srihari NN, Thomas C, Wagstaff J, Wylie J, Zarkar A, Parmar MKB, Sydes MR; STAMPEDE Investigators. Abiraterone for Prostate Cancer Not Previously Treated with Hormone Therapy. N Engl J Med. 2017 Jul 27;377(4):338-351. doi: 10.1056/NEJMoa1702900. Epub 2017 Jun 3.

Reference Type RESULT
PMID: 28578639 (View on PubMed)

Sydes MR, Spears MR, Mason MD, Clarke NW, Dearnaley DP, de Bono JS, Attard G, Chowdhury S, Cross W, Gillessen S, Malik ZI, Jones R, Parker CC, Ritchie AWS, Russell JM, Millman R, Matheson D, Amos C, Gilson C, Birtle A, Brock S, Capaldi L, Chakraborti P, Choudhury A, Evans L, Ford D, Gale J, Gibbs S, Gilbert DC, Hughes R, McLaren D, Lester JF, Nikapota A, O'Sullivan J, Parikh O, Peedell C, Protheroe A, Rudman SM, Shaffer R, Sheehan D, Simms M, Srihari N, Strebel R, Sundar S, Tolan S, Tsang D, Varughese M, Wagstaff J, Parmar MKB, James ND; STAMPEDE Investigators. Adding abiraterone or docetaxel to long-term hormone therapy for prostate cancer: directly randomised data from the STAMPEDE multi-arm, multi-stage platform protocol. Ann Oncol. 2018 May 1;29(5):1235-1248. doi: 10.1093/annonc/mdy072.

Reference Type RESULT
PMID: 29529169 (View on PubMed)

Parker CC, James ND, Brawley CD, Clarke NW, Hoyle AP, Ali A, Ritchie AWS, Attard G, Chowdhury S, Cross W, Dearnaley DP, Gillessen S, Gilson C, Jones RJ, Langley RE, Malik ZI, Mason MD, Matheson D, Millman R, Russell JM, Thalmann GN, Amos CL, Alonzi R, Bahl A, Birtle A, Din O, Douis H, Eswar C, Gale J, Gannon MR, Jonnada S, Khaksar S, Lester JF, O'Sullivan JM, Parikh OA, Pedley ID, Pudney DM, Sheehan DJ, Srihari NN, Tran ATH, Parmar MKB, Sydes MR; Systemic Therapy for Advanced or Metastatic Prostate cancer: Evaluation of Drug Efficacy (STAMPEDE) investigators. Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial. Lancet. 2018 Dec 1;392(10162):2353-2366. doi: 10.1016/S0140-6736(18)32486-3. Epub 2018 Oct 21.

Reference Type RESULT
PMID: 30355464 (View on PubMed)

Clarke NW, Ali A, Ingleby FC, Hoyle A, Amos CL, Attard G, Brawley CD, Calvert J, Chowdhury S, Cook A, Cross W, Dearnaley DP, Douis H, Gilbert D, Gillessen S, Jones RJ, Langley RE, MacNair A, Malik Z, Mason MD, Matheson D, Millman R, Parker CC, Ritchie AWS, Rush H, Russell JM, Brown J, Beesley S, Birtle A, Capaldi L, Gale J, Gibbs S, Lydon A, Nikapota A, Omlin A, O'Sullivan JM, Parikh O, Protheroe A, Rudman S, Srihari NN, Simms M, Tanguay JS, Tolan S, Wagstaff J, Wallace J, Wylie J, Zarkar A, Sydes MR, Parmar MKB, James ND. Addition of docetaxel to hormonal therapy in low- and high-burden metastatic hormone sensitive prostate cancer: long-term survival results from the STAMPEDE trial. Ann Oncol. 2019 Dec 1;30(12):1992-2003. doi: 10.1093/annonc/mdz396.

Reference Type RESULT
PMID: 31560068 (View on PubMed)

Gillessen S, Murphy L, James ND, Sachdeva A, El-Taji O, Abdel-Aty H, Adler AI, Amos C, Attard G, Varughese M, Gale J, Brown S, Srihari N, Birtle AJ, Brown M, Chan K, Chowdhury S, Cross W, Dearnaley DP, Din O, Dutey-Magni P, Gilbert DC, Gilson C, Gray S, Grist E, Hofmann U, Hudson AM, Jain Y, Jeyasangar G, Jones R, Kayani M, Langley RE, Malik Z, Mason MD, Matheson D, McAlpine C, Macnair A, Millman R, Murphy C, Padden-Modi M, Parikh O, Parker C, Rush H, Russell M, Srinivasan R, Sundar S, Tanguay JS, Turco F, Williams P, Sydes MR, Parmar MKB, Brown LC, Clarke NW; STAMPEDE investigators. Metformin for patients with metastatic prostate cancer starting androgen deprivation therapy: a randomised phase 3 trial of the STAMPEDE platform protocol. Lancet Oncol. 2025 Aug;26(8):1018-1030. doi: 10.1016/S1470-2045(25)00231-1. Epub 2025 Jul 7.

Reference Type DERIVED
PMID: 40639383 (View on PubMed)

Parker CTA, Mendes L, Liu VYT, Grist E, Joun S, Yamashita R, Mitani A, Chen E, Parry MA, Sachdeva A, Murphy L, Huang HC, Griffin J, van der Wal D, Todorovic T, Lall S, Santos Vidal S, Goncalves M, Thakali S, Wingate A, Zakka L, Brown M, Wetterskog D, Amos CL, Atako NB, Jones RJ, Cross WR, Gillessen S, Parker CC; STAMPEDE collaborators; Berney DM, Tran PT, Spratt DE, Sydes MR, Parmar MKB, Clarke NW, Brown LC, Feng FY, Esteva A, James ND, Attard G. External validation of a digital pathology-based multimodal artificial intelligence-derived prognostic model in patients with advanced prostate cancer starting long-term androgen deprivation therapy: a post-hoc ancillary biomarker study of four phase 3 randomised controlled trials of the STAMPEDE platform protocol. Lancet Digit Health. 2025 Jul;7(7):100885. doi: 10.1016/j.landig.2025.100885. Epub 2025 Jun 3.

Reference Type DERIVED
PMID: 40467357 (View on PubMed)

Gilbert DC, Nankivell M, Rush H, Clarke NW, Mangar S, Al-Hasso A, Rosen S, Kockelbergh R, Sundaram SK, Dixit S, Laniado M, McPhail N, Shaheen A, Brown S, Gale J, Deighan J, Marshall J, Duong T, Macnair A, Griffiths A, Amos CL, Sydes MR, James ND, Parmar MKB, Langley RE. A Repurposing Programme Evaluating Transdermal Oestradiol Patches for the Treatment of Prostate Cancer Within the PATCH and STAMPEDE Trials: Current Results and Adapting Trial Design. Clin Oncol (R Coll Radiol). 2024 Jan;36(1):e11-e19. doi: 10.1016/j.clon.2023.10.054. Epub 2023 Nov 8.

Reference Type DERIVED
PMID: 37973477 (View on PubMed)

Attard G, Murphy L, Clarke NW, Sachdeva A, Jones C, Hoyle A, Cross W, Jones RJ, Parker CC, Gillessen S, Cook A, Brawley C, Gilson C, Rush H, Abdel-Aty H, Amos CL, Murphy C, Chowdhury S, Malik Z, Russell JM, Parkar N, Pugh C, Diaz-Montana C, Pezaro C, Grant W, Saxby H, Pedley I, O'Sullivan JM, Birtle A, Gale J, Srihari N, Thomas C, Tanguay J, Wagstaff J, Das P, Gray E, Alzouebi M, Parikh O, Robinson A, Montazeri AH, Wylie J, Zarkar A, Cathomas R, Brown MD, Jain Y, Dearnaley DP, Mason MD, Gilbert D, Langley RE, Millman R, Matheson D, Sydes MR, Brown LC, Parmar MKB, James ND; STAMPEDE investigators. Abiraterone acetate plus prednisolone with or without enzalutamide for patients with metastatic prostate cancer starting androgen deprivation therapy: final results from two randomised phase 3 trials of the STAMPEDE platform protocol. Lancet Oncol. 2023 May;24(5):443-456. doi: 10.1016/S1470-2045(23)00148-1.

Reference Type DERIVED
PMID: 37142371 (View on PubMed)

Grist E, Friedrich S, Brawley C, Mendes L, Parry M, Ali A, Haran A, Hoyle A, Gilson C, Lall S, Zakka L, Bautista C, Landless A, Nowakowska K, Wingate A, Wetterskog D, Hasan AMM, Akato NB, Richmond M, Ishaq S, Matthews N, Hamid AA, Sweeney CJ, Sydes MR, Berney DM, Lise S; STAMPEDE investigators; Parmar MKB, Clarke NW, James ND, Cremaschi P, Brown LC, Attard G. Accumulation of copy number alterations and clinical progression across advanced prostate cancer. Genome Med. 2022 Sep 5;14(1):102. doi: 10.1186/s13073-022-01080-4.

Reference Type DERIVED
PMID: 36059000 (View on PubMed)

Parker CC, James ND, Brawley CD, Clarke NW, Ali A, Amos CL, Attard G, Chowdhury S, Cook A, Cross W, Dearnaley DP, Douis H, Gilbert DC, Gilson C, Gillessen S, Hoyle A, Jones RJ, Langley RE, Malik ZI, Mason MD, Matheson D, Millman R, Rauchenberger M, Rush H, Russell JM, Sweeney H, Bahl A, Birtle A, Capaldi L, Din O, Ford D, Gale J, Henry A, Hoskin P, Kagzi M, Lydon A, O'Sullivan JM, Paisey SA, Parikh O, Pudney D, Ramani V, Robson P, Srihari NN, Tanguay J, Parmar MKB, Sydes MR; STAMPEDE Trial Collaborative Group. Radiotherapy to the prostate for men with metastatic prostate cancer in the UK and Switzerland: Long-term results from the STAMPEDE randomised controlled trial. PLoS Med. 2022 Jun 7;19(6):e1003998. doi: 10.1371/journal.pmed.1003998. eCollection 2022 Jun.

Reference Type DERIVED
PMID: 35671327 (View on PubMed)

Attard G, Murphy L, Clarke NW, Cross W, Jones RJ, Parker CC, Gillessen S, Cook A, Brawley C, Amos CL, Atako N, Pugh C, Buckner M, Chowdhury S, Malik Z, Russell JM, Gilson C, Rush H, Bowen J, Lydon A, Pedley I, O'Sullivan JM, Birtle A, Gale J, Srihari N, Thomas C, Tanguay J, Wagstaff J, Das P, Gray E, Alzoueb M, Parikh O, Robinson A, Syndikus I, Wylie J, Zarkar A, Thalmann G, de Bono JS, Dearnaley DP, Mason MD, Gilbert D, Langley RE, Millman R, Matheson D, Sydes MR, Brown LC, Parmar MKB, James ND; Systemic Therapy in Advancing or Metastatic Prostate cancer: Evaluation of Drug Efficacy (STAMPEDE) investigators. Abiraterone acetate and prednisolone with or without enzalutamide for high-risk non-metastatic prostate cancer: a meta-analysis of primary results from two randomised controlled phase 3 trials of the STAMPEDE platform protocol. Lancet. 2022 Jan 29;399(10323):447-460. doi: 10.1016/S0140-6736(21)02437-5. Epub 2021 Dec 23.

Reference Type DERIVED
PMID: 34953525 (View on PubMed)

Rush HL, Murphy L, Morgans AK, Clarke NW, Cook AD, Attard G, Macnair A, Dearnaley DP, Parker CC, Russell JM, Gillessen S, Matheson D, Millman R, Brawley CD, Pugh C, Tanguay JS, Jones RJ, Wagstaff J, Rudman S, O'Sullivan JM, Gale J, Birtle A, Protheroe A, Gray E, Perna C, Tolan S, McPhail N, Malik ZI, Vengalil S, Fackrell D, Hoskin P, Sydes MR, Chowdhury S, Gilbert DC, Parmar MKB, James ND, Langley RE. Quality of Life in Men With Prostate Cancer Randomly Allocated to Receive Docetaxel or Abiraterone in the STAMPEDE Trial. J Clin Oncol. 2022 Mar 10;40(8):825-836. doi: 10.1200/JCO.21.00728. Epub 2021 Nov 10.

Reference Type DERIVED
PMID: 34757812 (View on PubMed)

Ali A, Hoyle A, Haran AM, Brawley CD, Cook A, Amos C, Calvert J, Douis H, Mason MD, Dearnaley D, Attard G, Gillessen S, Parmar MKB, Parker CC, Sydes MR, James ND, Clarke NW. Association of Bone Metastatic Burden With Survival Benefit From Prostate Radiotherapy in Patients With Newly Diagnosed Metastatic Prostate Cancer: A Secondary Analysis of a Randomized Clinical Trial. JAMA Oncol. 2021 Apr 1;7(4):555-563. doi: 10.1001/jamaoncol.2020.7857.

Reference Type DERIVED
PMID: 33599706 (View on PubMed)

Jakob T, Tesfamariam YM, Macherey S, Kuhr K, Adams A, Monsef I, Heidenreich A, Skoetz N. Bisphosphonates or RANK-ligand-inhibitors for men with prostate cancer and bone metastases: a network meta-analysis. Cochrane Database Syst Rev. 2020 Dec 3;12(12):CD013020. doi: 10.1002/14651858.CD013020.pub2.

Reference Type DERIVED
PMID: 33270906 (View on PubMed)

Roy S, Malone S, Grimes S, Morgan SC. Impact of Concomitant Medications on Biochemical Outcome in Localised Prostate Cancer Treated with Radiotherapy and Androgen Deprivation Therapy. Clin Oncol (R Coll Radiol). 2021 Mar;33(3):181-190. doi: 10.1016/j.clon.2020.09.005. Epub 2020 Sep 29.

Reference Type DERIVED
PMID: 32994091 (View on PubMed)

James ND, Sydes MR, Clarke NW, Mason MD, Dearnaley DP, Spears MR, Ritchie AW, Parker CC, Russell JM, Attard G, de Bono J, Cross W, Jones RJ, Thalmann G, Amos C, Matheson D, Millman R, Alzouebi M, Beesley S, Birtle AJ, Brock S, Cathomas R, Chakraborti P, Chowdhury S, Cook A, Elliott T, Gale J, Gibbs S, Graham JD, Hetherington J, Hughes R, Laing R, McKinna F, McLaren DB, O'Sullivan JM, Parikh O, Peedell C, Protheroe A, Robinson AJ, Srihari N, Srinivasan R, Staffurth J, Sundar S, Tolan S, Tsang D, Wagstaff J, Parmar MK; STAMPEDE investigators. Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial. Lancet. 2016 Mar 19;387(10024):1163-77. doi: 10.1016/S0140-6736(15)01037-5. Epub 2015 Dec 21.

Reference Type DERIVED
PMID: 26719232 (View on PubMed)

Huang X, Chau CH, Figg WD. Challenges to improved therapeutics for metastatic castrate resistant prostate cancer: from recent successes and failures. J Hematol Oncol. 2012 Jul 2;5:35. doi: 10.1186/1756-8722-5-35.

Reference Type DERIVED
PMID: 22747660 (View on PubMed)

Related Links

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Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

MRC-STAMPEDE

Identifier Type: OTHER

Identifier Source: secondary_id

EU-205102

Identifier Type: OTHER

Identifier Source: secondary_id

PR08

Identifier Type: OTHER

Identifier Source: secondary_id

ISRCTN78818544

Identifier Type: REGISTRY

Identifier Source: secondary_id

2004-000193-31

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

CDR0000455008

Identifier Type: -

Identifier Source: org_study_id

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