Randomised phase III trial of enzalutamide in androgen deprivation therapy (ADT) with radiation therapy for clinically localised, high risk, or node-positive prostate cancer: ENZARAD (ANZUP 1303).

Authors

null

Scott Williams

Peter MacCallum Cancer Centre, Melbourne, Australia

Scott Williams , Ian D. Davis , Christopher Sweeney , Martin R. Stockler , Andrew James Martin , Wendy Hague , Xanthi Coskinas , Sonia Yip , Emily Tu , Nicola Jane Lawrence , Ray McDermott , Paul J. Kelly , Olwyn Deignan , Simon Hughes , Valerie Fonteyne , Bertrand F. Tombal , Paul L. Nguyen

Organizations

Peter MacCallum Cancer Centre, Melbourne, Australia, Monash University and Eastern Health, Victoria, Australia, Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia, Sydney Catalyst Translational Cancer Research Centre, Sydney, Australia, ICORG, Dublin, Ireland, Cork University Hospital, Cork, Ireland, Cancer Trials Ireland, Dublin, Ireland, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom, Ghent University Hospital, Ghent, Belgium, Cliniques Universitaires Saint-Luc, Brussels, Belgium, Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA

Research Funding

Pharmaceutical/Biotech Company

Background: Adjuvant ADT with an LHRH analog (LHRHA) given before, during and after radiotherapy (RT) is standard of care for high risk localised prostate cancer (PC). Enzalutamide is more effective in metastatic disease than conventional non-steroidal anti-androgens (NSAA). We hypothesize that addition of enzalutamide to adjuvant ADT and RT will improve outcomes. The aim is to determine the efficacy of enzalutamide compared with NSAA as part of adjuvant ADT with LHRHA in men planned for RT for localized high risk or node-positive PC. Methods: DESIGN: Open label, randomised, phase 3 trial including ANZ, USA, UK, Ireland and Europe. ENDPOINTS: OS (primary), cause-specific survival, PSA PFS, clinical PFS, time to subsequent hormonal therapy, time to castration-resistant disease (PCWG2 criteria), metastasis free survival, adverse events and HRQOL. Tertiary objectives: identification of prognostic/predictive biomarkers from archival tumour tissue and 4 serial fasting bloods. 800 target participants with 5.5 yrs minimum follow-up. 80% power to detect 33% reduction in the hazard of death assuming 5-year survival rate of 76% amongst controls. TREATMENT: Participants are randomised 1:1 to enzalutamide 160mg daily for 24 months versus conventional NSAA for 6 months. All participants receive LHRHA for 24 months and RT starting after week 16. RT delivered as 78Gy in 39 Fx or 46Gy in 23 Fx plus brachytherapy (nodal RT optional for N0, mandatory for N1). ASSESSMENTS: Baseline, then every 8 weeks until year 2, then 3-4 monthly until year 5, 6-monthly until year 7, then annually. CT/MRI and bone scan at baseline, PSA progression, 6 monthly until re-initiation of ADT, when PCWG2 criteria for CRPC are met and then 3 monthly until evidence of metastases. As of 1st February 2017, 55 of 67 sites open with 398 patients recruited. EORTC sites expected to open from Quarter 1 2017. ENZARAD is an investigator-initiated cooperative group trial led by ANZUP Cancer Trials Group with funds and product from Astellas. ANZUP is supported by Cancer Australia and previously CI NSW. ClinicalTrials.gov: NCT02446444, ANZCTR: ACTRN12614000126617 Clinical trial information: NCT02446444

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Genitourinary (Prostate) Cancer

Track

Genitourinary Cancer—Prostate, Testicular, and Penile

Sub Track

Prostate Cancer–Local-Regional Disease

Clinical Trial Registration Number

NCT02446444

Citation

J Clin Oncol 35, 2017 (suppl; abstr TPS5096)

DOI

10.1200/JCO.2017.35.15_suppl.TPS5096

Abstract #

TPS5096

Poster Bd #

165a

Abstract Disclosures