AI May Predict Benefit with Hormone Therapy Plus Radiotherapy in Prostate Cancer

Artificial intelligence (AI) may predict which patients with intermediate-risk prostate cancer will benefit from short-term androgen deprivation therapy, according to findings from a recent study.

In particular, a predictive AI biomarker was developed using data from more than 5,000 patients. This information helped researchers determine what may be the common ground across patients with prostate cancer who benefited from short-term androgen deprivation therapy, as noted in a press release from ArteraAI, the developer of the technology used in the study.

Dr. Daniel Spratt explained the the effect that artificial intelligence can have on predicting treatment benefit in patients with prostate cancer.

“This is truly a milestone in the treatment for prostate cancer,” Dr. Daniel Spratt, chairman and professor of radiation oncology at University Hospitals Seidman Cancer Center and Case Western Reserve University in Cleveland, Ohio, said in the release. “With the first-ever predictive biomarker of (androgen deprivation therapy) benefit in prostate cancer, created with AI, we are able to further realize the ability to create a personalized approach for the treatment of cancer.”

Findings from this study, which were published in NEJM Evidence, demonstrated that androgen deprivation therapy (when medicines or surgery are used to decrease androgen levels made in the testicles) significantly improved the time to distant metastasis (cancer that has spread from the primary tumor to distant lymph nodes or organs). When researchers used the AI model on information from 5,727 patients with intermediate-risk prostate cancer, 34% were considered to have benefited from androgen deprivation therapy.

Radiotherapy is commonly given as a treatment with curative intent for patients with localized prostate cancer, the researchers wrote in the study. Since the 1980s, findings from trials have demonstrated that adding androgen deprivation therapy to radiotherapy can potentially improve outcomes. Despite these benefits, androgen deprivation therapy is associated with some side effects including loss of muscle mass, hot flashes, increase in body fat, declines in libido and erectile dysfunction, osteoporosis and toxic effects on brain and heart health, according to the study.

“Keeping patients from undergoing a treatment that would not provide therapeutic benefit, especially one that could do more harm than good, is everything to a clinician,” Dr. Felix Feng, scientific advisor to ArteraAI and professor of radiation oncology, urology at the University of California San Francisco, said in the release. “The validation of this biomarker by this highly credible and trusted publication is a milestone. We celebrate this achievement while also looking ahead to how we can build upon this evidence to continue transforming care for men diagnosed with localized prostate cancer.”

In the discussion section of the study, researchers noted that the current standard of care for men with intermediate-risk localized prostate cancer is adding short-term androgen deprivation therapy to radiotherapy. Even with improved outcomes, most men will not develop distant metastases when treated with radiotherapy alone and many men will have side effects as a result of treatment with androgen deprivation therapy.

“Unfortunately, there are no validated predictive models to guide (androgen deprivation therapy) use or duration in these men,” the researchers wrote.

The AI test assessed in this study utilized digital images from a patient’s biopsy and clinical data to predict whether a patient will benefit from a given therapy, as noted in the press release.

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