A randomised clinical trial aiming to improve survival in advanced prostate cancer by adapting treatment with a personalized dosing strategy has enrolled its first participants.
ANZadapt is a unique collaboration between two research groups from different continents: the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP) and the Leiden University Medical Center (LUMC) in the Netherlands. The teams were brought together and supported by the Anticancer Fund (ACF), a non-profit research organisation committed to improving outcomes for cancer patients.
ANZadapt is testing an innovative approach to treatment for people with castration-resistant prostate cancer (CRPC), which remains one of the most common causes of cancer-related death worldwide. The trial will test the idea of evolutionary therapy, also known as adaptive therapy. This will lead to a personalized treatment schedule, different for each participant.
Using approved hormone tablets for prostate cancer, abiraterone or enzalutamide, treatment will be given sparingly, for just long enough to control the cancer, followed by a break in treatment, then restarting the tablets later, aiming to improve the overall period of time that the hormone tablets can control the cancer. ANZadapt aims to prove if this adaptive strategy is better than the usual advice of taking the hormone tablets every day continuously.
Pilot studies of adaptive therapy, including an ANZUP-supported pilot study led by Australian principal investigator Assoc. Prof Craig Gedye, have suggested that pausing therapy when the cancer is stable, rather than continuous treatment that drives cancer cells to evolve, may prolong the benefit of treatment likely by delaying the emergence of treatment-resistant cancer cells.
The first participants enrolled marks the start of a journey to recruit and follow-up 168 eligible patients across Australia and the Netherlands. By collaborating across continents and aligning trial processes and protocols, ANZadapt has the potential to enroll and report quickly, and may lead to radical changes in treatment for people with prostate cancer.
“Whatever the outcome of this trial, ANZadapt will help answer an important question, and serve as a great model for future international collaborations,” Professor Ian Davis, ANZUP Chair.
“ANZadapt is a great example of how clinicians and patients around the world can work together to identify where evidence is required to address clinical needs, and then to do a trial like this to answer the question. Whatever the outcome of this trial, ANZadapt will help answer an important question, and serve as a great model for future international collaborations,” said Professor Ian Davis, ANZUP Chair.
“Bringing together two similar studies seemed logical to us, even if they came from opposite sides of the planet, but it required a lot of energy and effort from the respective study teams. We are very grateful the teams took the challenge. We strongly believe that both patients and the research community will benefit from this international trial,” said Dr Gauthier Bouche, Director of Clinical Research of the Anticancer Fund.
“The ANZadapt study may become a ground-breaking study in the field of oncology. If the study confirms that adaptive therapy is able to improve clinically important outcomes, not only patients with prostate cancer will benefit but it also paves the way for many more clinical trials investigating adaptive therapy in other cancers.”, said Dr Tom van der Hulle and Dr Dirk-Jan Moes, the principal investigators of the ANZadapt study in The Netherlands.
Source: ANZUP
