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Paul Edwards posted a topic in New agentsThe Malecare Advanced Prostate Cancer Blog reported on research data presented at the 7th European Multidisciplinary Meeting on Urological Cancers held in Barcelona from 12-15 November 2015. Patients who were treated with abiraterone acetate (Zytiga) or denosumab at the same time as they were treated with Ra-223 had better Overall Survival. Patients who had a good ECOG performance status*, no pain and low alkaline phosphatase (ALP)# had significantly longer Overall Survival. * ECOG performance status Clinical trials require the use of standard criteria for measuring how the disease impacts a patient’s daily living abilities (known to physicians and researchers as a patient’s performance status). The ECOG Scale of Performance Status is one such measurement. It describes a patient’s level of functioning in terms of their ability to care for themself, daily activity, and physical ability (walking, working, etc.). The scale was developed by the Eastern Cooperative Oncology Group (ECOG). # Alkaline phosphatase (ALP) This is a protein that the body produces mainly in the liver and in bones. With prostate cancer, elevated levels of ALP are associated with the formation of metastases in the bones.
The following is part of the Wikipedia article on Performance Status. Wikipedia article on Performance Status ECOG/WHO/Zubrod score The ECOG score (published by Oken et al. in 1982), also called the WHO or Zubrod score (after C. Gordon Zubrod), runs from 0 to 5, with 0 denoting perfect health and 5 death: Its advantage over the Karnofsky scale lies in its simplicity. 0 – Asymptomatic (Fully active, able to carry on all predisease activities without restriction) 1 – Symptomatic but completely ambulatory (Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature. For example, light housework, office work) 2 – Symptomatic, <50% in bed during the day (Ambulatory and capable of all self care but unable to carry out any work activities. Up and about more than 50% of waking hours) 3 – Symptomatic, >50% in bed, but not bedbound (Capable of only limited self-care, confined to bed or chair 50% or more of waking hours) 4 – Bedbound (Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair) 5 – Death Karnofsky scoring The Karnofsky score runs from 100 to 0, where 100 is "perfect" health and 0 is death. Although practitioners occasionally assign performance scores in between standard intervals of 10, there is no substantiated rationale for this and prognostication is not improved. This scoring system is named after Dr David A. Karnofsky, who described the scale with Dr Joseph H. Burchenal in 1949. 100% – normal, no complaints, no signs of disease 90% – capable of normal activity, few symptoms or signs of disease 80% – normal activity with some difficulty, some symptoms or signs 70% – caring for self, not capable of normal activity or work 60% – requiring some help, can take care of most personal requirements 50% – requires help often, requires frequent medical care 40% – disabled, requires special care and help 30% – severely disabled, hospital admission indicated but no risk of death 20% – very ill, urgently requiring admission, requires supportive measures or treatment 10% – moribund, rapidly progressive fatal disease processes 0% – death.