A new artificial intelligence test now promises to identify which men with prostate cancer could gain the most from abiraterone, a treatment shown to halve disease mortality in some cases.
While abiraterone has become life extending for many with advanced disease, its use in men whose cancer remains contained has been restricted in some areas, including England.
Researchers from the United States, United Kingdom, and Switzerland collaborated to create this advanced test, aiming to guide who should receive the drug and who could forgo it safely. The test made its debut at the American Society of Clinical Oncology conference in Chicago, drawing wide interest from cancer specialists.
Nick James, a leading researcher in London, emphasized that although abiraterone brings real survival gains, it carries potential side effects such as high blood pressure, changes in liver health, and rare but concerning risks for diabetes and heart issues. Knowing which patients truly benefit can avoid exposing many men to these complications.
Precision Medicine for Prostate Cancer
The artificial intelligence tool assesses digitized biopsy images, detecting tiny patterns unseen by pathologists. Over one thousand men with aggressive, but non metastatic, prostate cancer participated in clinical trials supported by charity and public research funding.
The test flagged a quarter of trial participants as most likely to benefit, offering these men a clear survival advantage. For this subset, death rates over five years dropped from seventeen percent to nine percent after being treated with abiraterone alongside regular therapy.
By contrast, men with biomarker negative results, according to the test, experienced only slight and statistically insignificant improvements. They can often do just as well without the drug, relying on hormone therapy and radiotherapy alone.
Study co leader Gert Attard from University College London hailed the results as a step forward in tailoring treatment, reducing unnecessary medication, and raising overall cure prospects. Professor James urged health services to reconsider their prescribing rules for abiraterone, highlighting that fewer patients than previously estimated would actually require it.
Currently, use of the drug is approved on the National Health Service in England for advanced disease, but not for men with high risk cancer that has not yet spread, even though Scotland and Wales have permitted prescriptions for this group for the last two years.
James noted the cost effectiveness of the therapy, stressing that new tests now make it possible to match the right treatment to the right patient and reduce waste for healthcare systems.
Matthew Hobbs of Prostate Cancer UK called on decision makers to act quickly so more men could benefit, now that clinicians have the means to select them accurately.
The NHS explained that while abiraterone remains standard for some prostate cancer cases, expanding access for men with localized but risky disease remains a top goal, pending the availability of ongoing funding and assessment of the role of liquid biopsy in advancing precision oncology.
