There is a need for clinically actionable prognostic and predictive tools to guide the management of oligometastatic castration-sensitive prostate cancer (omCSPC).
This is a multicenter retrospective study to assess the prognostic and predictive performance of a multimodal artificial intelligence biomarker (MMAI; the ArteraAI Prostate Test) in men with omCSPC (n = 222). The cohort also included 51 patients from the STOMP and ORIOLE phase 2 clinical trials which randomized patients to observation versus metastasis-directed therapy (MDT). MMAI scores were computed from digitized histopathology slides and clinical variables. Overall survival (OS) and time to castration-resistant prostate cancer (TTCRPC) were assessed for the entire cohort from time of diagnosis. Metastasis free survival (MFS) was assessed for the trial cohort from time of randomization.
In the overall cohort, patients with a high MMAI score had significantly worse OS (HR = 6.46, 95 % CI = 1.44-28.9; p = 0.01) and shorter TTCRPC (HR = 2.07, 95 % CI = 1.15-3.72; p = 0.015). In a multivariable Cox model, MMAI score remained the only variable significantly associated with OS (HR = 6.51, 95 % CI = 1.32-32.2; p = 0.02). In the subset of patients randomized in the STOMP and ORIOLE trials, high MMAI score corresponded to improved MFS with MDT (p = 0.039) compared to patients with a low score, with pinteraction = 0.04.
The ArteraAI MMAI biomarker is prognostic for OS and TTCRPC among patients with omCSPC and may predict for response to MDT. Further work is needed to validate the MMAI biomarker in a broader mCSPC cohort.
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2024 Nov 06 [Epub ahead of print]
Jarey H Wang, Matthew P Deek, Adrianna A Mendes, Yang Song, Amol Shetty, Soha Bazyar, Kim Van der Eecken, Emmalyn Chen, Timothy N Showalter, Trevor J Royce, Tamara Todorovic, Huei-Chung Huang, Scott A Houck, Rikiya Yamashita, Ana P Kiess, Daniel Y Song, Tamara Lotan, Theodore DeWeese, Luigi Marchionni, Lei Ren, Amit Sawant, Nicole Simone, Alejandro Berlin, Cem Onal, Andre Esteva, Felix Y Feng, Phuoc T Tran, Philip Sutera, Piet Ost
Johns Hopkins University, Baltimore, MD, USA., Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA., University of Maryland Medical Center, Baltimore, MD, USA., Ghent University Hospital, Ghent, Belgium., Artera Inc., Los Altos, CA, USA., Artera Inc., Los Altos, CA, USA; University of Virginia, Charlottesville, VA, USA., Weill Cornell Medical College, New York, NY, USA., Thomas Jefferson University, Philadelphia, PA, USA., Princess Margaret Cancer Centre, Toronto, Canada., Baskent University, Ankara, Turkey., Artera Inc., Los Altos, CA, USA; University of California San Francisco, San Francisco, CA, USA., University of Maryland Medical Center, Baltimore, MD, USA. Electronic address: ., University of Rochester Medical Center, Rochester, NY, USA. Electronic address: ., Department of Human Structure and Repair, Ghent University, Ghent, Belgium; Department of Radiation Oncology, Iridium Network, Antwerp, Belgium. Electronic address: .