Clatterbridge looks at using AI to improve treatment for prostate cancer patients

Researchers at The Clatterbridge Cancer Centre are harnessing artificial intelligence (AI) to enhance the precision of radiotherapy for prostate cancer.

A Clatterbridge research study aims to improve outcomes for patients with prostate cancer by giving clinicians more information and confidence in how to conduct life-saving treatment through an AI programme.

The PIVOTALboost study recently closed after surveying data from 2,232 patients across 49 healthcare centres in the UK. The results are now being analysed and could pave the way for more accurate and effective treatment for high-risk prostate cancer.

The study builds on research from the Netherlands, conducted between 2005 and 2008, in which the Flame clinical trial demonstrated that adding a ‘boost’ dose of radiotherapy to the tumour nodule within the prostate improved patient outcomes, including reduced relapse rates and fewer secondary cancers, without significantly increasing side effects. However, the study showed variability in how clinicians pinpointed tumour areas to target the boost dose.

To address this, the FLAME team are developing a computer algorithm trained on pathology specimens, creating a standardised method for identifying thee target areas using MRI scans.

The PIVOTALboost trial, which ran from 2018, evaluated whether the boost dose is beneficial in a shorter, four-week radiotherapy schedule compared to the eight-week timescale used in FLAME. Participants were randomised to either standard radiotherapy or radiotherapy with a boost.

Researchers at The Clatterbridge Cancer Centre (CCC) plan to apply an algorithm to MRI scans from trial participants, starting with those treated at CCC and London’s Royal Marsden Hospital, a partner in their Biomedical Research Centre (BRC) collaboration.

Dr Alex Batty, a clinical fellow at Clatterbridge funded by the BRC and Clatterbridge Cancer Charity, is leading efforts to integrate this algorithm into the PIVOTALboost trial analysis. He said:

“Our research focuses on using AI to standardise and refine how we deliver this boost dose of radiotherapy. The outcome could improve clinicians’ confidence in targeting specific areas of the prostate and ultimately make treatment more effective.”

Professor Isabel Syndikus, a CCC consultant oncologist and Chief Investigator in the project, emphasised the importance of validating the AI tool across different UK hospital sites. “With 49 trial centres using varied MRI scanners, importing and analysing the imaging data in this research is a major challenge,” she said. “But if we are successful, doing this will establish a robust and validated AI programme to assist clinicians in delivering prostate boost protocols with greater accuracy.”

Preliminary findings suggest that AI-driven contouring could reduce inconsistencies observed in the FLAME trial, where there was a 20% disagreement between clinicians’ interpretations and the algorithm’s suggestions. “Standardising this process could ensure that patients across the globe receive high-quality, evidence-based care,” said Professor Syndikus.

Experts are optimistic about the potential impact of the PIVOTALboost trial. Dr Batty said: “If the outcomes align with the FLAME trial, we could see a significant shift in prostate cancer treatment standards. AI tools like this could streamline workflows, save time, and improve patient outcomes.”

The analysis of the PIVOTALboost trial is a collaboration between CCC, which acts as sponsor, and the Clinical Trials Unit at The Royal Marsden, through the BRC. CCC is an Associate Partner in the National Institute of Health Research-funded BRC, awarded to The Royal Marsden and the Institute of Cancer Research.

Dr Gillian Heap, CCC’s Director of Research and Innovation Operations, said: “This collaboration bridges innovative technology with clinical practice and shows how important partnerships are in cancer research. If successful, this study will bring us closer to ensuring that every prostate cancer patient receives the best possible treatment for their disease.”