
Scientists have developed an artificial intelligence (AI) test that can predict which men with prostate cancer will benefit most from a drug that reduces the risk of dying. The life-extending drug called abiraterone has been called a 'gamechanger' treatment for the disease, but some countries are not offering it to men whose disease has not spread yet.
The new AI test, built by a team from the US, UK and Switzerland, shows which men would most likely benefit from abiraterone. The breakthrough will help doctors to prescribe the drug to more men and avoid spending on other unnecessary treatments.
"The natural history of advanced and aggressive prostate cancer is highly variable and now with better treatments, the risk of cancer relapse can be significantly reduced," said Professor Gert Attard, co-lead of the study.
"This study shows, in a very large cohort of patients, that novel AI algorithms can be used to extract information from routinely available pathology slides to tailor these treatments to specific patients and minimise overtreatment whilst maximising the chance of cure."
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The test uses AI to study images of tumours and examine features invisible to the human eye. The team trialled the test on biopsy images from more than 1,000 men with high-risk prostate cancer that had not spread.
Using the new AI test, researchers found that abiraterone given alongside standard hormone therapy almost halves the risk of death for approximately 25 per cent of men with prostate cancer.
Notably, abiraterone works by inhibiting the production of testosterone in all tissues throughout the body, including the tumour.
"This research shows that we can pick out the people who will respond best to abiraterone, and those who will do well from standard treatment alone - hormone therapy and radiotherapy," said Professor Nick James, co-lead of the trial.
"I truly hope that this new research, showing precisely who needs the drug to live well for longer will lead to NHS England reviewing their decision to fund abiraterone for high-risk prostate cancer that has not spread."
The trial results were presented at the American Society of Clinical Oncology (ASCO) Annual Meeting 2025.
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