BACKGROUNDApalutamide is an inhibitor of the ligand-binding domain of the androgen receptor. Whether the addition of apalutamide to androgen-deprivation therapy (ADT) would prolong radiographic progression-free survival and overall survival as compared with placebo plus ADT among patients with metastatic, castration-sensitive prostate cancer has not been determined. METHODSIn this double-blind, phase 3 trial, we randomly assigned patients with metastatic, castration-sensitive prostate cancer to receive apalutamide (240 mg per day) or placebo, added to ADT. Previous treatment for localized disease and previous docetaxel therapy were allowed. The primary end points were radiographic progression-free survival and overall survival. RESULTSA total of 525 patients were assigned to receive apalutamide plus ADT and 527 to receive placebo plus ADT. The median age was 68 years. A total of 16.4% of the patients had undergone prostatectomy or received radiotherapy for localized disease, and 10.7% had received previous docetaxel therapy; 62.7% had high-volume disease, and 37.3% had low-volume disease. At the first interim analysis, with a median of 22.7 months of follow-up, the percentage of patients with radiographic progression-free survival at 24 months was 68.2% in the apalutamide group and 47.5% in the placebo group (hazard ratio for radiographic progression or death, 0.48; 95% confidence interval [CI], 0.39 to 0.60; P<0.001). Overall survival at 24 months was also greater with apalutamide than with placebo (82.4% in the apalutamide group vs. 73.5% in the placebo group; hazard ratio for death, 0.67; 95% CI, 0.51 to 0.89; P = 0.005). The frequency of grade 3 or 4 adverse events was 42.2% in the apalutamide group and 40.8% in the placebo group; rash was more common in the apalutamide group. CONCLUSIONSIn this trial involving patients with metastatic, castration-sensitive prostate cancer, overall survival and radiographic progression-free survival were significantly longer with the addition of apalutamide to ADT than with placebo plus ADT, and the sideeffect profile did not differ substantially between the two groups. (Funded by Janssen Research and Development; TITAN ClinicalTrials.gov number, NCT02489318.

No abstract

No abstract

Stretchable and flexible sensors attached onto the surface of the human body can perceive external stimuli, thus attracting extensive attention due to their lightweight, low modulus, low cost, high flexibility, and stretchability. Recently, a myriad of efforts have been devoted to improving the performance and functionality of wearable sensors. Herein, this review focuses on recent remarkable advancements in the development of flexible and stretchable sensors. Multifunction of these wearable sensors is realized by incorporating some desired features (e.g., self-healing, self-powering, linearity, and printing). Next, focusing on the characteristics of carbon nanomaterials, nanostructured metal, conductive polymer, or their hybrid composites, two major strategies (e.g., materials that stretch and structures that stretch) and diverse design approaches have been developed to achieve highly flexible and stretchable electrodes. Strain sensing performances of recently reported sensors indicate that the appropriate choice of geometric engineering as well as intrinsically stretchable materials is essential for high-performance strain sensing. Finally, some important directions and challenges of a fully sensor-integrated wearable platform are proposed to realize their potential applications for human motion monitoring and human-machine interfaces.