{"api_version":"v1","slug":"proteus","name":"PROTEUS","occurrence_count":2,"occurrences":[{"date":"2026-08-29","conference":null,"disease_site":"prostate","study":{"name":"PROTEUS","tldr":"5-yr BCR-FS 44%, MFS 71%, CSS 92% at 60-mo median follow-up in a high-risk cohort.","details":["📊 5-yr BCR-FS 44%, 5-yr MFS 71%, 5-yr CSS 92%","📊 Median follow-up 60 mo","🔍 Source tweet frames this as a real-world benchmark to contextualize perioperative treatment strategies in a high-risk population","⚠️ Design not stated in source: no phase, N, arms, or comparator reported","⚠️ Treatment received (surgery, RT, systemic) not specified in source, so the outcomes cannot be attributed to a modality","⚠️ Eligibility and risk-group definition not given in source; \"high-risk\" is unqualified","⚠️ The BCR-FS / MFS / CSS gap (44% vs 71% vs 92% at 5 yr) is consistent with biochemical events outrunning clinical ones, but no competing-risk or per-event detail is reported in source","⚠️ #PROTEUS in the source may refer to the trial hashtag rather than the cohort reported; the tweet gives no registration or design linking the numbers to a named trial"],"figures":[],"nct":null,"doi":null,"tweet_ids":[74],"slug":"proteus","verdict":{"soc_implication":"unclear","rationale":"Source gives three 5-yr rates and follow-up only. No design, N, treatment, or comparator, so no SOC read is supportable.","audience":"High-risk prostate cancer; risk definition and treatment not specified in source"},"significance":null,"monday_clinic":null,"primary_endpoint":null,"analysis_sections":[{"label":"Results","body":"At **median follow-up 60 mo**: **5-yr BCR-FS 44%**, **5-yr MFS 71%**, **5-yr CSS 92%**. No per-arm, per-subgroup, or comparator figures reported in source."},{"label":"Limitations","body":"Beyond the missing design, the source names no treatment received, so the 44% biochemical failure rate cannot be read as a benchmark for any specific perioperative strategy. No N, no risk-stratification criteria, and no confidence intervals accompany the three rates."},{"label":"Applies to","body":"Represents a high-risk prostate cancer cohort as characterised in the source. Does not represent any defined stage, grade, or treatment group, since the source states none."}],"interpretation":null,"relevant_specialties":["radonc","medonc","surgonc"],"significance_by_specialty":null,"open_questions":["Which treatment produced these outcomes","Risk-group definition behind the 44% 5-yr BCR-FS","Whether perioperative systemic therapy improves on this benchmark"],"consort":null,"modality":null,"intent":null,"methodology":null,"related_trials":[{"nct":"NCT06627530","brief_title":"COACTION Trial - COmbination Androgen bloCkade in inTermediate to hIgh-risk prOstate caNcer","overall_status":"ACTIVE_NOT_RECRUITING","phase":["PHASE4"],"enrollment_count":144,"primary_completion_date":"2026-03","brief_summary":"A Randomized Trial of Neoadjuvant Leuprorelin, Darolutamide or Both Prior to Radical Prostatectomy for Intermediate or High-risk Prostate Cancer. Prospective, randomized, parallel group, open-label with blinded endpoint adjudication multicenter clinical trial.To assess, among patients with unfavorable intermediate to high-risk prostate cancer, whether a neoadjuvant combined treatment with leuprorelin (Leuprorelin) and darolutamide is superior to monotherapy in terms of complete or almost…","conditions":["Prostate Cancer"],"interventions":[{"name":"Darolutamide Oral Tablet","type":"DRUG"},{"name":"leuprorelin","type":"DRUG"}],"eligibility_brief":"Inclusion Criteria:\n\n* Men ≥18 years of age;\n* Histologically confirmed unfavorable intermediate or high/very high risk non metastatic (by conventional imaging) prostate adenocarcinoma intended for surgery without neuroendocrine differentiation or small cell features;\n* Unfavorable…","answers_question":"Whether perioperative systemic therapy improves on this benchmark","relevance_phrase":"randomised neoadj darolutamide ± leuprorelin pre-RP"},{"nct":"NCT07677566","brief_title":"177Lu-PSMA-617 Combined With Darolutamide in Neoadjuvant Treatment of High-risk Localized Prostate Cancer: a Prospective, Single-arm, Multi-center Clinical Trial","overall_status":"NOT_YET_RECRUITING","phase":["PHASE4"],"enrollment_count":20,"primary_completion_date":"2027-07","brief_summary":"The goal of this clinical trial is to explore the efficacy and safety of darolutamide combined with 177Lu-PSMA-617 in treating high-risk localized prostate cancer patients who are scheduled to undergo radical prostatectomy. The main questions it aims to answer are:\n\nDoes this combination treatment improve the pathological complete response rate (pCR)? What is the minimal residual disease (MRD) rate in these patients? What are the safety profiles and any adverse effects associated with this…","conditions":["Prostate Cancer","Prostate Cancer Patients"],"interventions":[{"name":"Darolutamide combined with 177Lu-PSMA-617","type":"DRUG"}],"eligibility_brief":"Inclusion Criteria:\n\n1. Patients must be ≥ 18 and ≤75 years of age\n2. All patients must have a histologically or cytologically diagnosis of prostate cancer，without distant metastasis, and suitable for radical prostatectomy\n3. All patients meet at least one of the following criteria： multi-parameter…","answers_question":"Whether perioperative systemic therapy improves on this benchmark","relevance_phrase":"single-arm neoadj Lu-PSMA + darolutamide, pCR pre-RP"}],"related_trials_provenance":{"queries_fired":["perioperative therapy high-risk prostate cancer"],"queries_failed":[],"candidates_returned":17,"fetched_at":"2026-08-30T08:00:34.951Z","rerank_outcome":"picked_N"},"source_ids":[{"type":"tweet","id":74}]}},{"date":"2026-05-31","conference":null,"disease_site":"prostate","study":{"name":"PROTEUS","tldr":"Most distant metastases were PSMA PET-detected (53.0% apalutamide, 60.7% comparator); no EFS or MFS effect size in source.","details":["🔍 Apalutamide + ADT vs ADT alone; trial design details not given in source tweets","📊 Majority of MFS events were PET-detected, not conventional imaging","📐 Distant mets found by PSMA PET: 53.0% apalutamide group vs 60.7% comparator arm","⚠️ NEJM quote truncated in source; comparator arm label inferred from a two-arm trial","⚠️ No EFS or MFS effect size reported in source tweets","⚠️ Differential PET detection can widen an MFS gap without a biologic difference","⚠️ Commentator hypothetical, not trial data: 100 pts/arm, 60 BCR on ADT vs 50 on APA+ADT","Framed pre-presentation as either a homerun or a large negative; full results pending"],"figures":[],"nct":null,"tweet_ids":[58,59,61],"slug":"proteus","verdict":{"soc_implication":"unclear","rationale":"Results online but the source thread carries no EFS or MFS effect size, so no strength bucket is defensible; ascertainment concern noted, not adjudicated.","audience":null},"significance":"53.0% of distant mets in the apalutamide group were PSMA PET-detected vs 60.7% in the comparator, so the arms differ in how events were found, not only how often. MFS surrogacy was built in the conventional-imaging era, which is the read this complicates. No effect size in source.","monday_clinic":null,"primary_endpoint":null,"analysis_sections":[{"label":"Endpoints","body":"**MFS** event ascertainment was PSMA PET-dominant: **53.0%** of distant metastases in the apalutamide group and **60.7%** in the comparator were identified by PET rather than conventional imaging. **EFS** is named in the thread, but **no effect size** for either endpoint appears in the source."},{"label":"Discussion","body":"The contested question is whether a PET-detected metastasis is the same event MFS was built to count. A commentator's hypothetical, explicitly **not trial data**, models 100 pts per arm with **60 BCRs** on ADT alone and **50** on apalutamide plus ADT to show how differential detection alone can widen an apparent gap."},{"label":"Limitations","body":"The NEJM sentence quoted in the thread is truncated, so the 60.7% figure's arm label is inferred from a two-arm comparison rather than read directly. The full presentation has not occurred, and the source gives no phase, N, follow-up, or eligibility."}],"interpretation":null,"relevant_specialties":["medonc"],"significance_by_specialty":{"medonc":"Whether apalutamide added to ADT earns its place turns on an MFS signal in which 53.0% (apalutamide) and 60.7% (comparator) of distant mets were PSMA PET-detected. Weigh the intensification decision against how much of any separation is detection rather than biology. No effect size in source."},"open_questions":["Whether the MFS separation holds under conventional-imaging-only ascertainment","Does the EFS signal translate to overall survival","How PSMA PET stage migration should be handled in MFS endpoints"],"consort":null,"modality":"systemic","intent":null,"methodology":null,"significance_perspective":"Radiation oncology","related_trials":null,"related_trials_provenance":{"queries_fired":["apalutamide prostate","PSMA PET prostate staging"],"queries_failed":[],"candidates_returned":39,"fetched_at":"2026-08-11T06:15:06.410Z","rerank_outcome":"abstained"},"source_ids":[{"type":"tweet","id":58},{"type":"tweet","id":59},{"type":"tweet","id":61}]}}]}