Brussels - The first of a planned 168 patients has been enrolled in a promising trial for the treatment of people with prostate cancer. The trial aims at personalising the treatment with an on/off-strategy, to prolong the response to the treatment and delay resistance. The trial is a unique collaboration of two research groups in two different countries, on different continents: The Netherlands and Australia. The Anticancer Fund incentivised them to work together to have a more meaningful impact on the outcome for prostate cancer patients.

The ANZadapt-trial is bringing together two similar studies that applied independently, but at the same time, for funding at the Anticancer Fund, a non-profit research organisation offering financial support: the ANZadapt-study led by the Leiden University Medical Center (LUMC) and the ANZUP-trial led by the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP). The two research groups were encouraged by the Anticancer Fund to align their protocols and to share data. Because no doubt, this cooperation should enhance much stronger results than the two studies ran separately.

The ANZadapt-trial has the ambition to be a game changer for people with castration-resistant prostate cancer (CRPC). Prostate cancer remains one of the most common causes of cancer related death, worldwide. The investigators integrate evolutionary dynamics in the treatment, also known as adaptive therapy. This will lead to a personalised, intermittent treatment of the patients.

On/Off-strategy

The therapy will consist of hormone tablets, abiraterone and enzalutamide, all approved to treat advanced prostate cancer. Small pilot studies have indicated that using hormone tablets sparingly, for just long enough to control the cancer, followed by a break in treatment and restarting them later, seems to improve the period of time hormone tablets can control the cancer. The trial aims to find out if this so called on/off-strategy, is better than taking hormone tablets every day continuously.

Earlier studies with a similar adaptive therapy-strategy have demonstrated that instead of killing as much cancer cells as you can and allowing resistance to emerge, pausing the therapy when the cancer is stable, can prolong the response to the treatment, and can delay the emergence of cancer resistant cells.

The first patient enrolled marks the start of the journey to recruit and follow-up 168 eligible patients across Australia, New Zealand, and The Netherlands.

The project has been facilitated and funded by the Anticancer Fund in Meise (Belgium), a non-profit organisation with an international scope, offering researchers scientific and financial support.

“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 Gauthier Bouche, Director Clinical research of the Anticancer Fund.

“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 in Australia.

"The ANZadapt study may become a ground breaking study in the field of oncology. When 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 Tom van der Hulle and Dirk-Jan Moes, the principal investigators of the ANZadapt study in The Netherlands.

Find out more about the ANZadapt trial

About the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP)

ANZUP is the leading cancer-cooperative clinical trials group that brings together all of the professional disciplines and groups involved in researching and treating urogenital cancers and conduct high quality clinical research. ANZUP identifies gaps in evidence and areas of clinical need, collaborates with the best clinicians and researchers in GU cancer and communicates frequently and effectively with the broader community along the way. ANZUP receives valuable infrastructure support from the Australian Government through Cancer Australia.

About Leids Universitair Medisch Centrum (LUMC)

The LUMC aims to improve healthcare and the health of our patients as an innovator. That is our mission. We do this through leading research projects and innovative educational programs. This leads to top clinical innovative care for our patients. The ANZadapt study is part of the ambition of the Medical Oncology Department to personalise oncological treatment, reduce side effect and toxicity and improve cost-effectiveness.