AI test could help prostate cancer patients avoid side effects of hormone therapy: ASTuTE trial
- Artificial intelligence could transform treatment decisions for prostate cancer patients and their doctors in Australia.
- GenesisCare-led research shows a significant opportunity to reduce unnecessary exposure to the side-effects of Short-Term Androgen Deprivation Therapy for men with intermediate-risk prostate cancer.
- Of 230 trial participants recommended Short-Term Androgen Deprivation Therapy, 176 - about 3 in 4 - went on to avoid it in consultation with their doctors.
- Among all 786 participants, findings show a 20.7% net reduction in the use of Short-Term Androgen Deprivation Therapy across the trial.
Sydney, Australia – Medical researchers say artificial intelligence (AI) can help doctors and patients decide who will benefit from Short-Term Androgen Deprivation Therapy (ST-ADT), with findings from the GenesisCare-led ASTuTE Trial showing a one-fifth or 20.7% net reduction in its use among the Australian men taking part in the research. GenesisCare has presented the findings at the American Society for Radiation Oncology (ASTRO) Annual Meeting in Boston.
Also known as hormone therapy, ST-ADT is a well-established treatment used to improve the efficacy of radiotherapy for men with intermediate-risk prostate cancer. Because prostate cancer needs testosterone to grow, ST-ADT is used to slow the production of this hormone and the growth of the cancer1. Added to radiotherapy it delivers a survival benefit of around 5%2 on average across all patients treated, meaning a large number of men treated bear the potential side effects without gaining significant clinical benefit. Over time, awareness of the impact of ST-ADT's side effects on quality of life has grown, as has the need for more informed treatment decisions2-5. Some of the potential harsh side effects can include sexual dysfunction, fatigue that doesn't go away with rest, hot flushes, osteoporosis, insomnia, diabetes, cardiovascular issues, and mental health effects such as depression and mood swings1.
Principal Investigator and GenesisCare Radiation Oncologist Dr Eric Wegener said: "The ASTuTE Trial findings show that when we use AI to help guide treatment decision-making, a lot of men and their doctors choose differently. Hormone therapy or ST-ADT saves lives, and for some men it is the right treatment choice when faced with prostate cancer. The trial shows that doctors and patients can use AI results to help decide whether ST-ADT is right for them, pointing to a future where some, if not most, men may not have to go through the potentially serious side-effects of the treatment."
“Every man with intermediate-risk prostate cancer has asked me some version of “do I really need this?” Of the men who were recommended for hormone therapy in the trial, three in four went a different way once they had their AI biomarker result.”
The ASTuTE clinical trial was launched in 2023, led by GenesisCare with investigators from public and private centres, universities and independent urology practices across Australia, to investigate how an AI-based precision medicine test may support shared treatment choices.
The multicentre trial of 786 participants collected real-world data on the effect of a multimodal artificial intelligence (MMAI) biomarker test on treatment decisions for men with intermediate-risk prostate cancer undergoing radiotherapy. Of the 230 men recommended ST-ADT before MMAI testing, 176 - about 3 in 4 - went on to avoid it. The test worked in both directions, also identifying 21 men as likely to benefit who had not been recommended it. Overall, ST-ADT use fell by 20.7%, or roughly one in five men. Researchers also found that clinicians recommended ST-ADT less often as the trial went on, before seeing any test result, suggesting the tool shifted clinical judgement more broadly.
The Artera AI Prostate Test used in the trial provides a prognostic estimate on the patient’s 10-year risk of the cancer spreading, as well as predictive information on the likely benefit of the addition of ST-ADT to radiotherapy for men diagnosed with intermediate risk prostate cancer. The test has been previously validated in a US clinical trial to predict when a patient would benefit from adding ST-ADT and when they would not6.
Read more about the ASTRO 2026 presentation.
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Cancer Council Australia. (n.d.). Androgen deprivation therapy (ADT) for prostate cancer. https://www.cancer.org.au/cancer-information/screening-tests-and-treatments/treatment/hormone-therapy
Patel, K. R., Spratt, D. E., Tran, P. T., Krauss, D. J., D'Amico, A. V., & Nguyen, P. L. (2025). The benefit of short-term androgen deprivation therapy with radiation therapy for intermediate-risk prostate cancer. International Journal of Radiation Oncology, Biology, Physics, 122(2), 407–415. https://doi.org/10.1016/j.ijrobp.2025.01.022
Savard, J., Ivers, H., Savard, M.-H., & Morin, C. M. (2015). Cancer treatments and their side effects are associated with aggravation of insomnia: Results of a longitudinal study. Cancer, 121(10), 1703–1711. https://doi.org/10.1002/cncr.29244
Dinh, K. T., Reznor, G., Muralidhar, V., Mahal, B. A., Nezolosky, M. D., Choueiri, T. K., Hoffman, K. E., Hu, J. C., Sweeney, C. J., Trinh, Q.-D., & Nguyen, P. L. (2016). Association of androgen deprivation therapy with depression in localized prostate cancer. Journal of Clinical Oncology, 34(16), 1905–1912. https://doi.org/10.1200/JCO.2015.64.1969
Nead, K. T., Sinha, S., Yang, D. D., & Nguyen, P. L. (2017). Association of androgen deprivation therapy and depression in the treatment of prostate cancer: A systematic review and meta-analysis. Urologic Oncology: Seminars and Original Investigations, 35(11), 664.e1–664.e9. https://doi.org/10.1016/j.urolonc.2017.07.016
Spratt, D. E., Tang, S., Sun, Y., Huang, H.-C., Chen, E., Mohamad, O., Armstrong, A. J., Tward, J. D., Nguyen, P. L., Lang, J. M., Zhang, J., Mitani, A., Simko, J. P., DeVries, S., van der Wal, D., Pinckaers, H., Monson, J. M., Campbell, H. A., Wallace, J., … Feng, F. Y. (2023). Artificial intelligence predictive model for hormone therapy use in prostate cancer. NEJM Evidence, 2(8), EVIDoa2300023. https://doi.org/10.1056/EVIDoa2300023
Disclaimer: The Artera AI Prostate Test was used in a clinical trial under the Australian Clinical Trial Notification Scheme and was approved by a Human Research Ethics Committee, but is not registered on the Australian Register of Therapeutic Goods.
Declaration of conflicting interests: GenesisCare and Artera AI are in a collaborative research partnership that is looking into biomarker testing. GenesisCare is a commercial entity that provides radiotherapy treatment, and which funded some of the conduct of the study.
The trial shows that doctors and patients can use AI results to help decide whether ST-ADT is right for them.
- Dr Eric Wegener, Radiation Oncologist, GenesisCare