Andrew Armstrong, MD, MSc, Duke University School of Medicine, and Christopher Wallis, MD, PhD, University of Toronto, discuss the design and implications of an AI-derived digital pathology-based biomarker to predict benefit of long-term ADT with radiotherapy in men with localized high-risk prostate, as well as HRQoL for patients with mCRPC who received abiraterone plus olaparib in the PROpel trial.
Dr. Armstrong and colleagues successfully validated the first predictive biomarker of long-term ADT benefit with RT in localized high-risk prostate cancer using an AI-derived digital pathology-based platform in the phase III NRG/RTOG 9202 trial. The biomarker identified 34% of men that could derive similar benefit with short-term ADT, avoiding the side effects of prolonged ADT, and 43% of intermediate-risk men who would benefit from long-term ADT.
Data from the final prespecified cutoff for PROpel showed a significant delay in rPFS for patients receiving abiraterone plus olaparib vs abiraterone plus placebo. Abiraterone plus olaparib showed no difference in HRQoL, suggesting patients can derive clinical benefit from this combination while maintaining a similar HRQoL compared with a current standard-of-care treatment.