Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2025
Development and Validation of an Artificial Intelligence Digital Pathology Biomarker to Predict Benefit of Long-Term Hormonal Therapy and Radiotherapy in Men With High-Risk Prostate Cancer Across Multiple Phase III Trials.
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed.
- Tumor‑immune spatiotemporal co‑evolution: A new paradigm for understanding and overcoming therapy resistance in metastatic castration‑resistant prostate cancer (Review).International journal of molecular medicine · 2026Review
- Article
- Review
- What practicing pathologists and oncologists should know about the new computational pathology-based companion diagnostic tools.The Journal of pathology · 2026Review
- What's new in digital and computational pathology 2026: advances in adoption, standards, AI technologies, and clinical integration.Journal of pathology and translational medicine · 2026Article
- MMHC-OCPR: Prediction of Platinum Response and Recurrence Risk in Ovarian Cancer with Multimodal Deep Learning.Biomedicines · 2026Article
- High-Risk Prostate Cancer Treated with Radiation Therapy: Favorable Outcomes in Men with PSA > 20 as the Sole High-Risk Factor.Journal of clinical medicine · 2026Article
- Article
- Sociodemographic Features, Health Care Costs, and Treatment Implications of Genomic Classifier Testing for Localized Prostate Cancer in the United States.JCO precision oncology · 2025Article
- Artificial intelligence-driven pathomics in hepatocellular carcinoma: current developments, challenges and perspectives.Discover oncology · 2025Review
- A Personalized Approach for Oligometastatic Prostate Cancer: Current Understanding and Future Directions.Cancers · 2025Review
- Utilization of artificial intelligence in prostate cancer detection: a comprehensive review of innovations in screening and diagnosis.Frontiers in immunology · 2025Review
- Artificial intelligence in oncology: promise, peril, and the future of patient-physician interaction.Frontiers in digital health · 2025Review
- Broadening the scope of artificial intelligence in oncology.Lancet regional health. Americas · 2023Article
- Discordant molecular biomarkers in unfavorable intermediate-risk localized prostate cancer.CA: a cancer journal for cliniciansArticle
Corrections and comments
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Authors and funding
27 authors.
Funding
Abstract
purposeLong-term androgen deprivation therapy (ADT) improves survival in men with high-risk localized prostate cancer (PCa) receiving radiotherapy (RT). Predictive biomarkers are needed to guide ADT duration.
methodsA multimodal artificial intelligence (MMAI)-derived predictive biomarker was trained for long-term (LT) versus short-term (ST) ADT using pretreatment digital prostate biopsy images and clinical data (age, prostate-specific antigen, Gleason, and T stage) from six NRG Oncology phase III randomized radiotherapy trials. The novel MMAI-derived biomarker was developed to predict the differential benefit of LT-ADT on the primary end point, distant metastasis (DM). MMAI predictive utility was validated on a seventh randomized trial, RTOG 9202 (N = 1,192), which randomly assigned men to RT + ST-ADT (4 months) versus RT + LT-ADT (28 months). Fine-Gray and cumulative incidence analyses for DM, and secondarily, death with DM, were performed. Deaths without DM were treated as competing risks.
resultsIn the validation cohort (median follow-up, 17.2 years), LT-ADT significantly improved DM from 26% to 17% (subdistribution hazard ratio [sHR], 0.64 [95% CI, 0.50 to 0.82],
conclusionTo our knowledge, the MMAI model is the first validated predictive biomarker to guide ADT duration with RT in localized/locally advanced PCa. Approximately one third of men with high-risk PCa could safely be spared the additional 24 months of ADT and the associated morbidity.
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