Randomised phase 3 trial of enzalutamide in androgen deprivation therapy (ADT) with radiation therapy for high risk, clinically localized 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 , Namrata Nayar , Ray McDermott , Paul Kelly , Olwyn Deignan , Simon Hughes , Valerie Fonteyne , Bertrand F. Tombal , Paul L. Nguyen

Organizations

Peter MacCallum Cancer Centre, Melbourne, Australia, Monash University Eastern Health Clinical School, Victoria, Australia, Dana-Farber Cancer Institute, Boston, MA, NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia, Cancer Trials Ireland, Dublin, Ireland, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom, European Organisation for Research and Treatment of Cancer, Brussels, Belgium

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 improves overall survival (OS) in castration-resistant, metastatic prostate cancer. We hypothesized that the addition of enzalutamide to adjuvant ADT and RT will improve outcomes. The aim is to determine the effects of enzalutamide versus a conventional non-steroidal anti-androgen (NSAA) as part of neoadjuvant and adjuvant ADT in men undergoing RT for high risk, localized PC. Methods: DESIGN: Open label, randomised, phase 3 trial including ANZ, USA, UK, Ireland and Europe. ENDPOINTS: OS (primary), cause-specific survival, PSA progression free survival (PFS), clinical PFS, time to subsequent hormonal therapy, time to castration-resistant disease (PCWG2 criteria), metastasis free survival (MFS), adverse events and health-related quality of life (HRQOL). CORRELATIVE OBJECTIVES: identification of prognostic/predictive biomarkers from archival tumour tissue and serial blood samples. SAMPLE SIZE: 800 participants with a minimum follow-up of 5.5 yrs is designed to give 80% power to detect 33% reduction in the hazard of death assuming 5-year survival rate of 76% amongst controls. TREATMENT: Enzalutamide 160mg daily for 24 months versus conventional NSAA for 6 months. All participants receive LHRHA for 24 months, and RT starting about week 16 delivered as 78Gy in 39#, or 46Gy in 23# 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. Imaging with CT/MRI and bone scan at baseline, PSA progression, then 6 monthly until re-initiation of ADT, when PCWG2 criteria for CRPC are met and then 3 monthly until evidence of metastases. 623 participants recruited from 61 sites as of 16 October 2017. ENZARAD is an investigator-initiated cooperative group trial led by ANZUP Cancer Trials Group with funds and product from Astellas. Clinical trial information: NCT02446444

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Abstract Details

Meeting

2018 Genitourinary Cancers Symposium

Session Type

Trials in Progress Poster Session

Session Title

Trials in Progress Poster Session A: Prostate Cancer

Track

Prostate Cancer,Prostate Cancer

Sub Track

Prostate Cancer - Localized Disease

Clinical Trial Registration Number

NCT02446444

Citation

J Clin Oncol 36, 2018 (suppl 6S; abstr TPS156)

DOI

10.1200/JCO.2018.36.6_suppl.TPS156

Abstract #

TPS156

Poster Bd #

N19

Abstract Disclosures