Cabozantinib Versus Mitoxantrone-prednisone in Symptomatic Metastatic Castration-resistant Prostate Cancer: A Randomized Phase 3 Trial with a Primary Pain Endpoint

Background: Bone metastases in patients with metastatic castration-resistant prostate cancer (mCRPC) are associated with debilitating pain and functional compromise. Objective: To compare pain palliation as the primary endpoint for cabozantinib versus mitoxantrone-prednisone in men with mCRPC and symptomatic bone metastases using patient-reported outcome measures. Design, setting, and participants: A randomized, double-blind phase 3 trial (COMET-2; NCT01522443) in men with mCRPC and narcotic-dependent pain from bone metastases who had progressed after treatment with docetaxel and either abiraterone or enzalutamide. Intervention: Cabozantinib 60 mg once daily orally versus mitoxantrone 12 mg/m2 every 3 wk plus prednisone 5 mg twice daily orally. Outcome measurements and statistical analysis: The primary endpoint was pain response at week 6 confirmed at week 12 (≥30% decrease from baseline in patient-reported average daily worst pain score via the Brief Pain Inventory without increased narcotic use). The planned sample size was 246 to achieve ≥90% power. Results and limitations: Enrollment was terminated early because cabozantinib did not demonstrate any survival benefit in the companion COMET-1 trial. At study closure, 119 participants were randomized (cabozantinib: N =61; mitoxantrone-prednisone: N = 58). Complete pain and narcotic use data were available at baseline, week 6, and week 12 for 73/106 (69%) patients. There was no significant difference in the pain response with cabozantinib versus mitoxantrone-prednisone: the proportions of responders were 15%versus 17%,a −2%difference(95%confidenceinterval:−16%to11%, p = 0.8). Barriers to accrual included pretreatment requirements for a washout period of prior anticancer therapy and a narcotic optimization period to maximize analgesic dosing. Conclusions: Cabozantinib treatment did not demonstrate better pain palliation than mitoxantrone-prednisone in heavily pretreated patients with mCRPC and symptomatic bone metastases. Future pain-palliation trials should incorporate briefer timelines from enrollment to treatment initiation. Patient summary: Cabozantinib was not better than mitoxantrone-prednisone for pain relief in patients with castration-resistant prostate cancer and debilitating pain from bone metastases

Low-latency gravitational wave alert products and their performance in anticipation of the fourth LIGO-Virgo-KAGRA observing run

Multi-messenger searches for binary neutron star (BNS) and neutron star-black hole (NSBH) mergers are currently one of the most exciting areas of astronomy. The search for joint electromagnetic and neutrino counterparts to gravitational wave (GW)s has resumed with Advanced LIGO (aLIGO)'s, Advanced Virgo (AdVirgo)'s and KAGRA's fourth observing run (O4). To support this effort, public semi-automated data products are sent in near real-time and include localization and source properties to guide complementary observations. Subsequent refinements, as and when available, are also relayed as updates. In preparation for O4, we have conducted a study using a simulated population of compact binaries and a Mock Data Challenge (MDC) in the form of a real-time replay to optimize and profile the software infrastructure and scientific deliverables. End-to-end performance was tested, including data ingestion, running online search pipelines, performing annotations, and issuing alerts to the astrophysics community. In this paper, we present an overview of the low-latency infrastructure as well as an overview of the performance of the data products to be released during O4 based on a MDC. We report on expected median latencies for the preliminary alert of full bandwidth searches (29.5 s) and for the creation of early warning triggers (-3.1 s), and show consistency and accuracy of released data products using the MDC. This paper provides a performance overview for LVK low-latency alert structure and data products using the MDC in anticipation of O4

Considerations for biomarker-targeted intervention strategies for tuberculosis disease prevention.

CAPRISA, 2018.Abstract available in pdf

gwpy/pyomicron: pyomicron 2.0.6

<p>Changes:</p> <ul> <li>[#157] Fix typo in omicron-process message</li> <li>[#159] Add support for Python 3.11</li> <li>[#163] Correctly import default segment host</li> <li>[#168] Remove unused variable</li> </ul> <p>For full details, see <a href="https://github.com/gwpy/pyomicron/milestone/21">https://github.com/gwpy/pyomicron/milestone/21</a></p&gt

QoQ: a Q-transform based test for Gravitational Wave transient events

The observation of transient gravitational waves is hindered by the presence of transient noise, colloquially referred to as glitches. These glitches can often be misidentified as gravitational waves by searches for unmodeled transients using the excess-power type of methods and sometimes even excite template waveforms for compact binary coalescences while using matched filter techniques. They thus create a significant background in the searches. This background is more critical in getting identified promptly and efficiently within the context of real-time searches for gravitational-wave transients. Such searches are the ones that have enabled multi-messenger astrophysics with the start of the Advanced LIGO and Advanced Virgo data taking in 2015 and they will continue to enable the field for further discoveries. With this work we propose and demonstrate the use of a signal-based test that quantifies the fidelity of the time-frequency decomposition of the putative signal based on first principles on how astrophysical transients are expected to be registered in the detectors and empirically measuring the instrumental noise. It is based on the Q-transform and a measure of the occupancy of the corresponding time-frequency pixels over select time-frequency volumes; we call it ``QoQ''. Our method shows a 40% reduction in the number of retraction of public alerts that were issued by the LIGO-Virgo-KAGRA collaborations during the third observing run with negligible loss in sensitivity. Receiver Operator Characteristic measurements suggest the method can be used in online and offline searches for transients, reducing their background significantly.Comment: 39 Figures, 5 Table

Cabozantinib versus mitoxantrone-prednisone in symptomatic metastatic castration-resistant prostate cancer : a randomized phase 3 trial with a primary pain endpoint

Background: Bone metastases in patients with metastatic castration-resistant prostate cancer (mCRPC) are associated with debilitating pain and functional compromise. Objective: To compare pain palliation as the primary endpoint for cabozantinib versus mitoxantrone-prednisone in men with mCRPC and symptomatic bone metastases using patient-reported outcome measures. Design, setting, and participants: A randomized, double-blind phase 3 trial (COMET-2; NCT01522443) in men with mCRPC and narcotic-dependent pain from bone metastases who had progressed after treatment with docetaxel and either abiraterone or enzalutamide. Intervention: Cabozantinib 60 mg once daily orally versus mitoxantrone 12 mg/m2 every 3 wk plus prednisone 5 mg twice daily orally. Outcome measurements and statistical analysis: The primary endpoint was pain response at week 6 confirmed at week 12 (≥30% decrease from baseline in patient-reported average daily worst pain score via the Brief Pain Inventory without increased narcotic use). The planned sample size was 246 to achieve ≥90% power. Results and limitations: Enrollment was terminated early because cabozantinib did not demonstrate a survival benefit in the companion COMET-1 trial. At study closure, 119 participants were randomized (cabozantinib: N = 61; mitoxantrone-prednisone: N = 58). Complete pain and narcotic use data were available at baseline, week 6, and week 12 for 73/106 (69%) patients. There was no significant difference in the pain response with cabozantinib versus mitoxantrone-prednisone: the proportions of responders were 15% versus 17%, a −2% difference (95% confidence interval: −16% to 11%, p = 0.8). Barriers to accrual included pretreatment requirements for a washout period of prior anticancer therapy and a narcotic optimization period to maximize analgesic dosing. Conclusions: Cabozantinib treatment did not demonstrate better pain palliation than mitoxantrone-prednisone in heavily pretreated patients with mCRPC and symptomatic bone metastases. Future pain-palliation trials should incorporate briefer timelines from enrollment to treatment initiation. Patient summary: Cabozantinib was not better than mitoxantrone-prednisone for pain relief in patients with castration-resistant prostate cancer and debilitating pain from bone metastases. Control of debilitating pain is an unmet need for men with metastatic castration-resistant prostate cancer (mCRPC). This phase 3 trial failed to show an improved pain response for cabozantinib compared with mitoxantrone-prednisone in patients with previously treated, symptomatic mCRPC