science

STAMPEDE (clinical trial)

STAMPEDE (clinical trial) is a science topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand STAMPEDE (clinical trial) rather than just read about it. In short: Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy (STAMPEDE) is a clinical trial investigating treatments for high risk or terminal prostate cancer. Recruitment started in 2005 and ended in 2022; as of January 2020, over 10,000 participants had joined the trial.

Key takeaways

STAMPEDE (clinical trial) belongs to science; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect STAMPEDE (clinical trial) to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of STAMPEDE (clinical trial) from memory before moving on to harder problems.

Reference excerpt

Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy (STAMPEDE) is a clinical trial investigating treatments for high risk or terminal prostate cancer. Recruitment started in 2005 and ended in 2022; as of January 2020, over 10,000 participants had joined the trial.

Name

STAMPEDE is an acronym for "Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy".

Aims and procedure The trial investigates new approaches for men with metastatic and locally advanced prostate cancer. 117 hospitals in the UK and Switzerland are involved with over 10,000 men are expected to take part in the trial. The men are randomly assigned to one of a number of "arms". The primary outcome by which the arms were judged is overall survival. The following arms are documented in the publicly available literature.

Arm A Standard of care (SOC) is lifelong androgen deprivation therapy (ADT). After 2015 SOC was expanded to include docetaxel and radiotherapy (RT) at the start of treatment.

Arm B SOC plus zoledronic acid.

Arm C Standard care plus docetaxel and prednisolone.

Arm D SOC plus celecoxib.

Arm E SOC plus zoledronic acid and docetaxel.

Arm F SOC plus zoledronic acid and celecoxib.

Arm G SOC plus abiraterone acetate and prednisolone.

Arm H SOC plus RT.

Arm J SOC plus abiraterone and enzalutamide and prednisolone.

Arm K SOC plus metformin.

Arm L SOC with transdermal oestradiol replacing standard ADT.

Results James, Sydes & Clarke 2016 reported that "the addition of docetaxel to standard of care was associated with improved survival, with an HR of 0·78 and a difference in median survival of 10 months, as well as improvements in prostate-cancer-specific survival, failure-free survival, and skeletal-related events". They also noted that docetaxel plus zoledronic acid "was associated with similar improvements, although the benefit observed was smaller". The overall conclusion was that "standard of care should be updated to include docetaxel chemotherapy in suitable patients with metastatic disease, and docetaxel may be considered for men with high-risk non-metastatic prostate cancer with or without radiotherapy". Parker, James & Brawley 2018 reported on radiotherapy. For patients with a high metastatic burden the radiotherapy did not improve survival. No improvement was noted for unselected patients, but for men with a low burden overall survival did improve. There is some discussion as to how the burden is identified (CT and bone scans versus PET). The findings may also be applicable to other cancers where there is a small volume. Cancer Research UK 2019 presents the main findings as:

adding docetaxel to hormone therapy improves the length of time men live – this is called overall survival adding abiraterone to hormone therapy improves overall survival and delays the time until the cancer gets worse adding radiotherapy to hormone therapy in men with less prostate cancer spread improves overall survival celecoxib doesn’t help men live longer.

See also Prostate Adenocarcinoma: TransCutaneous Hormones (PATCH)

References

Bibliography Cancer Research UK (31 January 2019), A trial looking at hormone therapy with other treatments for prostate cancer (STAMPEDE trial results), retrieved 12 October 2019 James, Nicholas D; Sydes, Matthew R; Clarke, Noel W; et al. (19 March 2016), "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", The Lancet, 387 (10024): 1163–77, doi:10.1016/S0140-6736(15)01037-5, PMC 4800035, PMID 26719232 Medical Research Council (7 November 2018), "Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy (STAMPEDE)", U.S. National Library of Medicine, retrieved 12 October 2019 Parker, Christopher C; James, Nicholas D; Brawley, Christopher D; et al. (1 December 2018), "Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial", The Lancet, 392 (10162): 2353–2366, doi:10.1016/S0140-6736(18)32486-3, PMC 6269599, PMID 30355464

External links STAMPEDE website

Worked examples

Example 1 — a first encounter with STAMPEDE (clinical trial)

Start with the simplest possible case. Write down what STAMPEDE (clinical trial) claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to STAMPEDE (clinical trial) before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about STAMPEDE (clinical trial) ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of STAMPEDE (clinical trial)

In research: STAMPEDE (clinical trial) appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses STAMPEDE (clinical trial) in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: STAMPEDE (clinical trial) is common in secondary-school and first-year university syllabi. It links to neighbouring topics Clinical trials, Prostate cancer, so understanding it makes those chapters shorter.
In everyday life: Look for STAMPEDE (clinical trial) outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study STAMPEDE (clinical trial) in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what STAMPEDE (clinical trial) means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain STAMPEDE (clinical trial) out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is STAMPEDE (clinical trial) in simple terms?

Why does STAMPEDE (clinical trial) matter?

Because it connects several science ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study STAMPEDE (clinical trial)?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on STAMPEDE (clinical trial).