Kah Min Tan

Purpose: The Decipher Prostate Genomic Classifier (GC) and ArteraAI Multimodal Artificial Intelligence (MMAI) platform are widely used prognostic tools for localized prostate cancer, yet no direct comparison has been performed within the same patient cohort. Experimental Design: We sought to evaluate the concordance and prognostic value of GC and MMAI across multi-institutional cohorts totaling 688 patients with localized and oligometastatic prostate cancer. These included populations enriched for African American and East Asian patients. GC and MMAI scores were stratified into risk groups based on specimen type [biopsy or radical prostatectomy (RP)]. The primary endpoint was distant metastasis–free survival, measured from diagnosis to last follow-up or event. Results: GC and MMAI scores were significantly correlated across multiple cohorts. In Moffitt RP, biopsy, and National Cancer Centre Singapore cohorts, both MMAI and GC were prognostic alone and after adjusting for clinical variables. Multivariable analysis, including both biomarkers and clinical variables, showed that MMAI was significant even when accounting for GC in Moffitt RP and borderline in Moffitt biopsy. Analysis of concordant/discordant cases showed that patients who were high risk for both GC and MMAI did qualitatively worse. In pathway analysis, concordance with GC and MMAI was high for Moffitt RP and oligometastatic patients. Across both biopsy cohorts, although most biological pathways were concordant, there were consistent discordant signaling, metabolic, and DNA repair pathways. Conclusions: In the first direct patient-level comparison of GC and MMAI in prostate cancer, these biomarkers were found to demonstrate moderate correlation, and both biomarkers demonstrated prognostic value across diverse populations and disease states.

Differentially abundant transcripts

Differential RNA abundance of driver cancer genes, using DEseq2 with the default parameter lfcThreshold = 0

Ratios of single-base substitution types, for the two radioresistant cell line, in 3 replicates each

Association between CNA events in seven candidate genes and BCR, using a log-rank test

Supporting data for differential RNA abundance analysis

The difference in RNA abundance of a PCNA isoform (ENST00000379143.10) and POLD1 isoforms (ENST00000440232.7 and ENST00000596648.1)

Supplementary Table 14 from The Proteogenomics of Prostate Cancer Radioresistance