Wang Jarey H, Deek Matthew P, Mendes Adrianna A, Song Yang, Shetty Amol, Bazyar Soha, Van der Eecken Kim, Chen Emmalyn, Showalter Timothy N, Royce Trevor J, Todorovic Tamara, Huang Huei-Chung, Houck Scott A, Yamashita Rikiya, Kiess Ana P, Song Daniel Y, Lotan Tamara, DeWeese Theodore, Marchionni Luigi, Ren Lei, Sawant Amit, Simone Nicole, Berlin Alejandro, Onal Cem, Esteva Andre, Feng Felix Y, Tran Phuoc T, Sutera Philip, Ost Piet
Johns Hopkins University, Baltimore, MD, USA.
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Radiother Oncol. 2025 Jan;202:110618. doi: 10.1016/j.radonc.2024.110618. Epub 2024 Nov 6.
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 p = 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.
需要有临床可操作的预后和预测工具来指导寡转移性去势敏感性前列腺癌（omCSPC）的管理。
这是一项多中心回顾性研究，旨在评估多模态人工智能生物标志物（MMAI；ArteraAI前列腺检测）在omCSPC患者（n = 222）中的预后和预测性能。该队列还包括来自STOMP和ORIOLE 2期临床试验的51名患者，这些试验将患者随机分为观察组与转移导向治疗（MDT）组。MMAI评分由数字化组织病理学切片和临床变量计算得出。从诊断时起评估整个队列的总生存期（OS）和去势抵抗性前列腺癌发生时间（TTCRPC）。从随机分组时起评估试验队列的无转移生存期（MFS）。
在整个队列中，MMAI评分高的患者OS明显更差（HR = 6.46，95%CI = 1.44 - 28.9；p = 0.01），TTCRPC更短（HR = 2.07，95%CI = 1.15 - 3.72；p = 0.015）。在多变量Cox模型中，MMAI评分仍然是与OS显著相关的唯一变量（HR = 6.51，95%CI = 1.32 - 32.2；p = 0.02）。在STOMP和ORIOLE试验中随机分组的患者亚组中，与低分患者相比，MDT治疗的高MMAI评分患者MFS有所改善（p = 0.039），p值为0.04。
ArteraAI MMAI生物标志物对omCSPC患者的OS和TTCRPC具有预后价值，并可能预测对MDT的反应。需要进一步开展工作，在更广泛的mCSPC队列中验证MMAI生物标志物。
