Iter-4360dd15-0078-two-pmid-evidence-verification

第 78 轮：剩余两个 PMID 的证据核验与最终判定

本轮只做一件事：用可公开访问的 web snippet 再核对剩余两个候选 PMID 的研究类型、年龄判据和主要终点，并把保留/排除判定钉死。

PMID 35040506

- 题名：mTOR Inhibition with Sirolimus in Multiple System Atrophy: A Randomized, Double-Blind, Placebo-Controlled Futility Trial and 1-Year Biomarker Longitudinal Analysis
- 研究类型：randomized, double-blind, placebo-controlled futility trial；并带 1-year biomarker longitudinal analysis
- 年龄判据：ClinicalTrials.gov / 公开页面与先前抽取一致，入组年龄 30–80 岁
- 主要终点：48-week change in UMSARS total score
- 判定：排除，原因不是后续分析，而是疾病特异性神经退行病试验，终点为 UMSARS，而非寿命/死亡/健康寿命
- 可核对来源：
- PubMed: https://pubmed.ncbi.nlm.nih.gov/35040506/?dopt=Abstract
- Europe PMC: https://europepmc.org/article/MED/35040506
- PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9018525/
- web snippet 明确给出 “Objective: To investigate the efficacy and safety of sirolimus in patients with MSA using a futility design. We also analyzed 1-year biomarker trajectories in the trial participants.”

PMID 29992557

- 题名：Efficacy and safety of everolimus plus exemestane in postmenopausal women with hormone receptor-positive, HER2-negative locally advanced or metastatic breast cancer: Results of the single-arm, phase IIIB 4EVER trial
- 研究类型：open-label, single-arm, phase IIIB trial
- 年龄判据：postmenopausal women
- 主要终点：progression-free survival (PFS) / overall response rate（公开 trial page snippet 指向 ORR 为 primary objective；PubMed/公开摘要语境同时强调 PFS 作为疾病控制语境）
- 判定：排除，原因是肿瘤治疗研究，终点属于疾病控制，不是直接 longevity 证据
- 可核对来源：
- PubMed: https://pubmed.ncbi.nlm.nih.gov/29992557/
- ClinicalTrials.gov: https://clinicaltrials.gov/study/NCT01626222
- web snippet: “This trial evaluated the clinical effectiveness of everolimus plus exemestane in postmenopausal women…”

统一判定规则复用

- older adults 或 postmenopausal women 不能单独构成 longevity 证据。
- survival 字样若落在 oncology 的 PFS 语境中，仍是疾病控制终点，不是长寿终点。
- longitudinal analysis 不能自动排除；必须看它是否与主试验并列、是否为同一受试者的附加分析。

结果

- 这两个剩余 PMID 均已完成证据核验，且都应排除为非直接 longevity 证据。
- 本轮推进点是把“剩余两个候选”的保留/排除状态从抽象分类落到可引用证据。