***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Therapeutic strategy remains unclear with no clear consensus for men with high-risk prostate cancer ( PCa ) after radical prostatectomy . We aim ed to evaluate into a prospect i ve r and omized trial the effectiveness and feasibility of adjuvant weekly paclitaxel combined with and rogen deprivation therapy ( ADT ) in these patients . A total of 47 patients with high-risk PCa were r and omized 6 weeks after radical prostatectomy : ADT alone versus combination of ADT and weekly paclitaxel .  Toxicity , quality -of-life and functional results were compared between the two arms . All 23 patients completed eight cycles of paclitaxel .  Toxicity was predominantly of grade 1–2 severity . There were no differences in EORTC QLQ-C30 scores between the two groups and between baseline and last assessment at 24 months after surgery . Urinary continence was complete at 1 year after surgery for all patients and no significant differences were noted at each assessment between the two groups . The interim analysis of this trial confirms the feasibility of weekly paclitaxel in combination with ADT in men at high-risk PCa with curative intent . This adjuvant combined therapy does not alter quality -of-life and continence recovery after surgery plus ADT . A larger cohort is awaited to determine the oncological outcomes of this strategy Treatment of high‐risk localized prostate cancer remains inadequate . The authors performed a phase 2 multicenter trial of neoadjuvant docetaxel plus bevacizumab before radical prostatectomy Background The optimal management of high-risk prostate cancer remains uncertain . In this study we assessed the safety and efficacy of a novel multimodal treatment paradigm for high-risk prostate cancer . Methods This was a prospect i ve phase II trial including 35 patients with newly diagnosed high-risk localized or locally advanced prostate cancer treated with high-dose intensity-modulated radiation therapy preceded or not by radical prostatectomy , concurrent intensified-dose docetaxel-based chemotherapy and long-term and rogen deprivation therapy .  Primary endpoint was acute and late toxicity evaluated with the Common Terminology Criteria for Adverse Events version 3.0 . Secondary endpoint was biochemical and clinical recurrence-free survival explored with the Kaplan-Meier method . Results Acute gastro-intestinal and genito-urinary toxicity was grade 2 in 23 % and 20 % of patients , and grade 3 in 9 % and 3 % of patients , respectively . Acute blood/bone marrow toxicity was grade 2 in 20 % of patients . No acute grade ≥4 toxicity was observed . Late gastro-intestinal and genito-urinary toxicity was grade 2 in 9 % of patients each . No late grade ≥3 toxicity was observed . Median follow-up was 63 months ( interquartile range 31–79 ) . Actuarial 5-year biochemical and clinical recurrence-free survival rate was 55 % ( 95 % confidence interval , 35 - 75 % ) and 70 % ( 95 % confidence interval , 52 - 88 % ) , respectively . Conclusions In our phase II trial testing a novel multimodal treatment paradigm for high-risk prostate cancer , toxicity was acceptably low and mid-term oncological outcome was good . This treatment paradigm , thus , may warrant further evaluation in phase III r and omized trials PURPOSE Trial RTOG 9202 was a phase 3 r and omized trial design ed to determine the optimal duration of and rogen deprivation therapy ( ADT ) when combined with definitive radiation therapy ( RT ) in the treatment of locally advanced nonmetastatic adenocarcinoma of the prostate . Long-term follow-up results of this study now available are relevant to the management of this disease . METHODS AND MATERIAL S Men ( N=1554 ) with adenocarcinoma of the prostate ( cT2c-T4 , N0-Nx ) with a prostate-specific antigen ( PSA ) < 150 ng/mL and no evidence of distant metastasis were r and omized ( June 1992 to April 1995 ) to short-term ADT ( STAD : 4 months of flutamide 250 mg 3 times per day and goserelin 3.6 mg per month ) and definitive RT versus long-term ADT ( LTAD : STAD with definitive RT plus an additional 24 months of monthly goserelin ) . RESULTS Among 1520 protocol -eligible and evaluable patients , the median follow-up time for this analysis was 19.6 years . In analysis adjusted for prognostic covariates , LTAD improved disease-free survival ( 29 % relative reduction in failure rate , P<.0001 ) , local progression ( 46 % relative reduction , P=.02 ) , distant metastases ( 36 % relative reduction , P<.0001 ) , disease-specific survival ( 30 % relative reduction , P=.003 ) , and overall survival ( 12 % relative reduction , P=.03 ) . Other-cause mortality ( non-prostate cancer ) did not differ ( 5 % relative reduction , P=.48 ) . CONCLUSIONS LTAD and RT is superior to STAD and RT for the treatment of locally advanced nonmetastatic adenocarcinoma of the prostate and should be considered the st and ard of care Purpose Systemic Therapy for Advanced or Metastatic Prostate Cancer : Evaluation of Drug Efficacy is a r and omized controlled trial using a multiarm , multistage , platform design . It recruits men with high-risk , locally advanced or metastatic prostate cancer who were initiating long-term hormone therapy . We report survival data for two celecoxib (Cel)-containing comparisons , which stopped accrual early at interim analysis on the basis of failure-free survival . Patients and Methods St and ard of care ( SOC ) was hormone therapy continuously ( metastatic ) or for ≥ 2 years ( nonmetastatic ) ; prostate ( ± pelvic node ) radiotherapy was encouraged for men without metastases . Cel 400 mg was administered twice a day for 1 year . Zoledronic acid ( ZA ) 4 mg was administered for six 3-weekly cycles , then 4-weekly for 2 years . Stratified r and om assignment allocated patients 2:1:1 to SOC ( control ) , SOC + Cel , or SOC + ZA + Cel . The primary outcome measure was all-cause mortality . Results were analyzed with Cox proportional hazards and flexible parametric models adjusted for stratification factors . Results A total of 1,245 men were r and omly assigned ( Oct 2005 to April 2011 ) . Groups were balanced : median age , 65 years ; 61 % metastatic , 14 % N+/X M0 , 25 % N0M0 ; 94 % newly diagnosed ; median prostate-specific antigen , 66 ng/mL. Median follow-up was 69 months . Grade 3 to 5 adverse events were seen in 36 % SOC-only , 33 % SOC + Cel , and 32 % SOC + ZA + Cel patients . There were 303 control arm deaths ( 83 % prostate cancer ) , and median survival was 66 months . Compared with SOC , the adjusted hazard ratio was 0.98 ( 95 % CI , 0.80 to 1.20 ; P = .847 ; median survival , 70 months ) for SOC + Cel and 0.86 ( 95 % CI , 0.70 to 1.05 ; P = .130 ; median survival , 76 months ) for SOC + ZA + Cel . Preplanned subgroup analyses in men with metastatic disease showed a hazard ratio of 0.78 ( 95 % CI , 0.62 to 0.98 ; P = .033 ) for SOC + ZA + Cel . Conclusion These data show no overall evidence of improved survival  with Cel . Preplanned subgroup analyses provide hypotheses for future studies Study Type – Therapy ( phase 1 BACKGROUND This was a phase I study to find the maximum tolerable dose ( MTD ) of weekly docetaxel combined with high-dose intensity-modulated radiotherapy ( IMRT ) and and rogen deprivation therapy ( ADT ) . PATIENTS AND METHODS Men with localized high-risk prostate cancer ( HRPC ) were treated with weekly docetaxel at 10 to 30 mg/m(2 ) concurrent with IMRT of 77.4 Gy to the prostate and 45 Gy to the seminal vesicles . ADT consisted of a gonadotropin-releasing hormone agonist ( GnRHa ) and bicalutamide beginning 2 months before and during chemoradiation . GnRHa was continued for 24 months . RESULTS Nineteen patients were enrolled .  No dose-limiting toxicity ( DLT ) was seen with docetaxel doses up to 25 mg/m(2 ) . At the 30 mg/m(2 ) level , 2 of 4 patients experienced DLTs of both grade 3 fatigue and dyspepsia . At 41 months ' median follow-up , 2 patients had died--1 from metastatic prostate cancer and the other from heart failure . Two other patients experienced biochemical failure . One patient with bladder invasion at diagnosis experienced late grade 2 urinary hesitancy 9 months after completion of radiotherapy , requiring short-term intermittent catheterization . All patients had erectile dysfunction , but no late toxicities worse than grade 2 were identified . CONCLUSION Weekly docetaxel may be combined with high-dose IMRT and long-term ADT up to a MTD of 25 mg/m(2 ) . Acute toxicities and long-term side effects of this regimen were acceptable . Future studies evaluating the efficacy of docetaxel , ADT , and IMRT for localized HRPC should use a weekly dose of 25 mg/m(2 ) when limiting the irradiated volume to the prostate and seminal vesicles BACKGROUND Prostate cancer ( PC ) is the most commonly diagnosed noncutaneous malignancy in American men . PC , which exhibits a slow growth rate and multiple potential target epitopes , is an ideal c and i date for immunotherapy . GVAX for prostate cancer is a cellular immunotherapy , composed of PC-3 cells ( CG1940 ) and LNCaP cells ( CG8711 ) . Each of the components is a prostate adenocarcinoma cell line that has been genetically modified to secrete granulocyte-macrophage colony-stimulating factor . Hypothesizing that GVAX for prostate cancer could be effective in a neoadjuvant setting in patients with locally advanced disease , we initiated a phase II trial of neoadjuvant docetaxel and GVAX . For the trial , the clinical effects of GVAX were assessed in patients undergoing radical prostatectomy ( RP ) . METHODS Patients received docetaxel administered at a dose of 75 mg/m(2 ) every 3 weeks for 4 cycles . GVAX was administered 2 - 3 days after chemotherapy preoperatively for four courses of immunotherapy . The first dose of GVAX was a prime immunotherapy of 5 × 10(8 ) cells . The subsequent boost immunotherapies consisted of 3 × 10(8 ) cells . After RP , patients received an additional six courses of immunotherapy . Pathologic complete response , toxicity , and clinical response were assessed . The primary endpoint of the trial was a pathologic state of pT0 , which is defined as no evidence of cancer in the prostate . RESULTS Six patients completed  neoadjuvant docetaxel and GVAX therapy . No serious drug-related adverse events were observed . Median change in prostate-specific antigen ( PSA ) following neoadjuvant therapy was 1.47 ng/ml . One patient did not undergo RP due to the discovery of positive lymph nodes during exploration . Of the five patients completing RP , four had a downstaging of their Gleason score . Undetectable PSA was achieved in three patients at 2 months after RP and in two patients at 3 years after RP . CONCLUSIONS Neoadjuvant docetaxel/GVAX is safe and well tolerated in patients with high-risk locally advanced PC . No evidence of increased intraoperative hemorrhage or increased length of hospital stay postoperatively was noted . These results justify further study of neoadjuvant immunotherapy To determine long‐term oncological outcomes of radical prostatectomy ( RP ) after neoadjuvant chemohormonal therapy ( CHT ) for clinical ly localised , high‐risk prostate cancer PURPOSE To evaluate the efficacy and safety profile of vinorelbine and estramustine in combination with three-dimensional conformational radiotherapy ( 3D-CRT ) in patients with localized high-risk prostate cancer . METHODS AND MATERIAL S Fifty patients received estramustine , 600 mg/m(2 ) daily , and vinorelbine , 25 mg/m(2 ) , on days 1 and 8 of a 21-day cycle for three cycles in combination with 8 weeks of 3D-CRT ( total dose of 70.2 gray [ Gy ] at 1.8-Gy fractions or 70 Gy at 2.0-Gy fractions ) . Additionally , patients received luteinizing hormone-releasing hormone analogs for 3 years . RESULTS All patients were evaluated for response and toxicity . Progression-free survival at 5 years was 72 % ( 95 % confidence interval [ CI ] : 52 - 86 ) . All patients who relapsed had only biochemical re 
    Output:
    
According to multiple r and omized trials , combining and rogen deprivation therapy ( ADT ) with external-beam radiotherapy ( EBRT ) outperforms EBRT alone for both relapse-free and overall survival .
Neoadjuvant ADT did not show significant improvement compared with prostatectomy alone .
GETUG 12 , RTOG 0521 , and nonmetastatic subgroup of the STAMPEDE trial showed improved relapse-free survival for docetaxel in patients treated with EBRT plus ADT , although mature metastasis-free survival data are still pending .
Both the SPCG-12 and the VACSP#553 trial showed no improvement in relapse-free survival for adjuvant docetaxel after prostatectomy .
In contrast to the clearly demonstrated survival benefits of long-term adjuvant ADT when used with EBRT , its role after prostatectomy remains unclear especially in pN0 patients .
Adding docetaxel to EBRT-ADT improves relapse-free survival , with immature results on overall survival .