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Thus we aim to evaluate the toxicity and efficacy of three different systemic therapies (docetaxel, zoledronic acid and celecoxib) used alone or combined at the initiation of hormone manipulation for high\u2010risk prostate cancer. A novel statistical design (multi\u2010arm, multistage method) simultaneously tests multiple distinct strategies in parallel against a single control arm. The trial has several \u2018stages\u2019, from initial confirmation of safety to a phase III assessment of survival, with a series of intervening activity stages. This method provides a means of assessing several agents more quickly and efficiently, and allows inactive treatments to be dropped from further study at an early stage. STAMPEDE has been designed to address in parallel the activity and efficacy of these agents for this patient group. It is a flagship randomized clinical trial for academic research into prostate cancer in the UK. More than 500 patients have been recruited on schedule, confirming the acceptability of this complex trial design to patients and clinicians. The trial targets a population of \u22483000 patients.<\/jats:p>\n                  <jats:p>STAMPEDE is a major new trial with a novel design applicable to the synchronous testing of several agents. It is hoped that the results will improve outcomes for patients with high\u2010risk prostate cancer. The design could be applicable to the study of new therapies in other cancer types. Continued efforts are required by the urological cancer community to maintain the excellent recruitment shown to date.<\/jats:p>","DOI":"10.1111\/j.1464-410x.2008.08034.x","type":"journal-article","created":{"date-parts":[[2008,10,9]],"date-time":"2008-10-09T09:39:55Z","timestamp":1223545195000},"page":"464-469","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":86,"title":["Systemic therapy for advancing or metastatic prostate cancer (STAMPEDE): a multi\u2010arm, multistage randomized controlled trial"],"prefix":"10.1111","volume":"103","author":[{"given":"Nicholas D.","family":"James","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R.","family":"Sydes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel W.","family":"Clarke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm D.","family":"Mason","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Dearnaley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Popert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Sanders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel C.","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Stansfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Dwyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Masters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh K.B.","family":"Parmar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,2,2]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040720"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041318"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.4008"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-07-0944"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410x.2000.00894.x"},{"issue":"3","key":"e_1_2_9_7_2","first-page":"81","article-title":"Randomized comparison of total androgen blockade alone versus combined with weekly epirubicin in advanced prostate cancer","volume":"32","author":"Pummer K","year":"1997","journal-title":"Eur Urol"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djg038"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djk178"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/94.19.1458"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djh141"},{"key":"e_1_2_9_12_2","unstructured":"NCCF.Prostate cancer: diagnosis and treatment. 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