Volume 387, Issue 10024, Pages 1163-1177 (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  Prof Nicholas D James, PhD, Matthew R Sydes, MSc, Prof Noel W Clarke, ChM, Prof Malcolm D Mason, MD, Prof David P Dearnaley, MD, Melissa R Spears, MSc, Alastair W S Ritchie, MD, Christopher C Parker, MD, J Martin Russell, FRCR, Gerhardt Attard, MD PhD, Prof Johann de Bono, PhD, William Cross, PhD, Prof Rob J Jones, PhD, Prof George Thalmann, MD, Claire Amos, PhD, David Matheson, PhD, Robin Millman, Mymoona Alzouebi, FRCR, Sharon Beesley, FRCR, Alison J Birtle, MD, Susannah Brock, FRCR, Richard Cathomas, MD, Prabir Chakraborti, FRCR, Simon Chowdhury, MD, Audrey Cook, FRCR, Tony Elliott, PhD, Joanna Gale, DM, Stephanie Gibbs, FRCR, John D Graham, FRCP, John Hetherington, FRCS[Eng], Robert Hughes, FRCR, Robert Laing, FRCR, Fiona McKinna, FRCR, Duncan B McLaren, FRCR, FRCP[Ed], Prof Joe M O'Sullivan, MD, Omi Parikh, FRCR, Clive Peedell, FRCR, Andrew Protheroe, PhD, Angus J Robinson, FRCR, Narayanan Srihari, MD, Rajaguru Srinivasan, FRCR, John Staffurth, MD, Santhanam Sundar, FRCR, Shaun Tolan, MD, David Tsang, MCRP, Prof John Wagstaff, MD, Prof Mahesh K B Parmar, DPhil  The Lancet  Volume 387, Issue 10024, Pages 1163-1177 (March 2016) DOI: 10.1016/S0140-6736(15)01037-5 Copyright © 2016 James et al. Open Access article distributed under the terms of CC BY Terms and Conditions

Figure 1 Trial profile SOC-only=standard of care only. SOC + ZA=standard of care plus zoledronic acid. SOC + Doc=standard of care plus docetaxel. SOC + ZA + Doc=standard of care plus zoledronic acid and docetaxel. The Lancet 2016 387, 1163-1177DOI: (10.1016/S0140-6736(15)01037-5) Copyright © 2016 James et al. Open Access article distributed under the terms of CC BY Terms and Conditions

Figure 2 Failure-free and overall survival Figure shows Kaplan-Meier curves and flexible parametric models fitted to the data. Number at risk (events) shows the number of individuals at risk (ie, the number who were event free) at each timepoint, with parentheses showing the number of individuals who developed events in the period between each timepoint. SOC-only=standard of care only. SOC + ZA=standard of care plus zoledronic acid. SOC + Doc=standard of care plus docetaxel. SOC + ZA + Doc=standard of care plus zoledronic acid and docetaxel. The Lancet 2016 387, 1163-1177DOI: (10.1016/S0140-6736(15)01037-5) Copyright © 2016 James et al. Open Access article distributed under the terms of CC BY Terms and Conditions

Figure 3 Forest plots of treatment effect on survival within subsets Data are deaths/N or HR (95% CI). All p values were statistically non-significant. For SOC-only vs SOC + ZA, all p>0·09, PSA p=0·116, time-period p=1·000. For SOC-only vs SOC + Doc, all p>0·06, PSA p=0·589, time-period p=1·000. For SOC-only vs SOC + ZA + Doc, all p>0·23 except previously treated p=0·023, PSA p=0·254, time-period p=1·000. X axis provided with natural log scaling. SOC-only=standard of care only. SOC + ZA=standard of care plus zoledronic acid. SOC + Doc=standard of care plus docetaxel. SOC + ZA + Doc=standard of care plus zoledronic acid and docetaxel. PSA=prostate-specific antigen. NSAID=non-steroidal anti-inflammatory drug. The Lancet 2016 387, 1163-1177DOI: (10.1016/S0140-6736(15)01037-5) Copyright © 2016 James et al. Open Access article distributed under the terms of CC BY Terms and Conditions

Figure 4 Time to treatment after progression Figure shows treatments ever used at relapse, at the discretion of the treating clinician, by group, cumulative incidence curves. (A) Time to any treatment after progression. (B) Time to any life-prolonging treatment after progression. (C) Time to docetaxel after progression. (D) Time to abiraterone after progression. SOC-only=standard of care only. SOC + ZA=standard of care plus zoledronic acid. SOC + Doc=standard of care plus docetaxel. SOC + ZA + Doc=standard of care plus zoledronic acid and docetaxel. FFS=failure-free survival. The Lancet 2016 387, 1163-1177DOI: (10.1016/S0140-6736(15)01037-5) Copyright © 2016 James et al. Open Access article distributed under the terms of CC BY Terms and Conditions