Data Availability
The data that support the findings of this study included pathology slides, clinicopathologic variables, and outcomes information from NRG Oncology. Data may be made available for noncommercial academic use from the authors with permission from NRG Oncology. For access to the clinicopathology variables and outcomes information, please contact [email protected]. For the digitized pathology slides, please contact A.E. ([email protected]).
Code Availability
The multi-modal AI architecture was developed using PyTorch Python library (https://pytorch.org/). In addition, scikit-learn, NumPy, statsmodels, pandas, Matplotlib, and MoCo-v2 have been used for computation and plotting (available under: https://scikit-learn.org/stable/, https://numpy.org/, https://www.statsmodels.org/, https://pandas.pydata.org/, https://matplotlib.org/, and https://github.com/facebookresearch/moco). The trained model used in this study has not yet undergone regulatory review and cannot be made available at this time. Interested researchers can contact A.E. (aesteva@artera.ai) for questions on its status and access.
Acknowledgements
This project was supported by grants U10CA180868 (NRG Oncology Operations), U10CA180822 (NRG Oncology SDMC), UG1CA189867 (NCORP), U24CA196067 (NRG Specimen Bank) from the National Cancer Institute (NCI). This work was also funded by Artera, Inc. The authors would like to thank Florence Lo, Asad Ullah, and Jen Chieh Lee for digitizing the histopathology slides, as well as the accrual authors listed under the NRG Prostate Cancer AI Consortium.
Author Contributions
A.E. and F.Y.F. conceptualized the study, assembled the team, and advised this work. A.E. conceptualized the AI system, prepared the data, and trained the models. A.E, SC.H., and D.vdW. developed the multi-modal AI architecture. A.G., N.N., D.N., and E.C. supported data preprocessing and contributed to model development. R.S., J.Z., M.L., and S.Y. advised the multi-modal AI architecture. J.F. and Y.S. performed statistical analyses and model validation. J.P.S. directed histology slide preparation for scanning and annotated the image clusters. S.D. digitized the histopathology slides. F.Y.F., E.M.S., T.M.M., A.E.R., and P.T.T. provided strategic guidance and urology domain expertise. F.Y.F., H.M.S., T.M.P., J.M.M., M.R., F.N., J.W., M.J.F., and JP.B. supported patient accrual for all clinical trials in this study. S.P. and the NRG Prostate Cancer AI Consortium prepared and collected the data for all clinical trials in this study for over 20 years. D.E.S., A.E., F.Y.F., and E.C. prepared the manuscript with input from all authors. O.M. and F.Y.F. assembled the clinical team, obtained the dataset, and managed the scanning operations for slide digitization. O.M. and F.Y.F. contributed equally as co-last authors.
Competing Interests
A.E., D.vdW., and E.C. are employees at Artera. A.E., D.vdW., D.N., R.S. and N.N are or were employees of Salesforce.com, Inc. F.Y.F. is an advisor to and holds equity in Artera and is a consultant for Janssen, Roivant, Myovant, Bayer, Novartis, Varian, Blue Earth Diagnostics and Exact Sciences. L.S. received travel support and honorarium from Varian Medical Systems and is on the advisory board for AbbVie. M.K. received funding from Limbus AI, is a consultant for Palette Life Sciences, and is on the advisory board for AbbVie, Ferring, Janssen, and TerSera. A.E.R. is a consultant for Astellas, Bayer, Blue Earth, Janssen, Myovant, Pfizer, Progenics, and Veracyte. H.S. is a member of the ASTRO Board and a member of the clinical trials steering committee for Janssen. P.T.T. is a consultant for Johnson & Johnson, RefleXion Medical, Myovant and AstraZeneca. D.E.S. is a consultant for AstraZeneca, Blue Earth, Bayer, Boston Scientific, Gammatile, Janssen, Novartis, and Varian. The remaining authors declare no competing interests.
NRG Prostate Cancer AI Consortium
Felix Y. Feng4, Howard M. Sandler18, Michael Kucharczyk22, Luis Souhami23, Leslie Ballas24, Christopher A. Peters25, Sandy Liu26, Alexander G. Balogh27, Pamela D. Randolph-Jackson28, David L. Schwartz29, Michael R. Girvigian30, Naoyuki G. Saito31, Adam Raben32, Rachel A. Rabinovitch33, Khalil Katato34
22Department of Radiation Oncology, Accrual-Nova Scotia Cancer Centre, Halifax, Nova Scotia, Canada, B3H 1V7
23Department of Oncology, The Research Institute of the McGill University Health Centre (MUHC), Montreal, QC H4A 3J1 CA
24Department of Radiation Oncology, University of Southern California, Los Angeles, CA
25Department of Radiation Oncology, Northeast Radiation Oncology Centers (NROC), Dunmore, PA
26Department of Medical Oncology, UCLA Medical Center, Los Angeles, CA
27Department of Radiation Oncology, Tom Baker Cancer Centre, Calgary, AB T2N 4N2 CA
28Department of Radiation Oncology, Washington Cancer Institute, Washington, DC
29Department of Radiation Oncology, Veteran Affairs New York Harbor Healthcare System-Brooklyn Campus, Brooklyn, NY
30Department of Radiation Oncology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
31Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN
32Department of Radiation Oncology, Christiana Care Health System-Christiana Hospital, Newark, DE
33Department of Radiation Oncology, University of Colorado Hospital, Aurora, CO
34Department of Medical Oncology, Hurley Medical Center, Flint, MI