NCT07260435RecruitingPhase 3
Apa/Enza-short Study: Shorter Treatment With Androgen Receptor Pathway Inhibitor in Patients With Low-volume Metastatic Castration-sensitive Prostate Cancer
Apa/Enza Short Study: Shortened 12 Months Duration of Androgen Receptor Signaling Agent in Combination With Androgen Deprivation Therapy in Patients With Low Volume Castration-sensitive Prostate Cancer: a Randomized Nationwide Study
Source: ClinicalTrials.gov · Last updated 3 Dec 2025
Brief summary (registry, in English)
The goal of this clinical trial is to evaluate the outcomes of a shorter treatment duration (12 months) with an androgen receptor pathway inhibitor (ARPI), in this study Apalutamide or Enzalutamide, in patients with low-volume, hormone-sensitive metastatic prostate cancer (mCSPC), with the possibility to restart treatment if needed. The main research question is whether discontinuation of ARPI therapy after 12 months, with the option to restart treatment upon disease progression, is non-inferior to continued ARPI therapy, potentially reducing toxicity and costs. Eligible patients will be randomized after completing 12 months of ARPI treatment, to one of the following two arms: 1. ADT + continued ARPI (Apalutamide or Enzalutamide) 2. ADT + ARPI discontinued after 12 months, with the option to resume ARPI in case of a confirmed PSA rise. The confirmatory PSA sample must be obtained at least 4 weeks after the initial rise. This study aims to minimize toxicity associated with prolonged use of ARPIs in patients with low-volume, hormone-sensitive metastatic prostate cancer.
- Status (registry)
- Recruiting
- Phase (registry)
- Phase 3
- Study type
- Interventional
- Enrollment
- 400 (estimated)
- First submitted
- 21 Nov 2025
- Start date
- Feb 2024
- Primary completion date
- Nov 2027
- Lead sponsor
- Nick Beije
- Diseases
- Prostate cancer
- NCT number
- NCT07260435
What you commit to
- Study type: Interventional · Phase 3
- Planned participants: 400
- From Feb 2024 to the primary completion date, Nov 2027
- 26 sites in 1 country
- Visits and tests: ask the trial team, the registry does not list them
Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.
Who cannot take part
Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.
Prior treatment
- Any other prior treatment for prostate cancer other than ADT (e.g., other next generation anti-androgens or other CYP17 inhibitors, chemotherapy, immunotherapy, or radiopharmaceutical agents)
- ADT started more than 6 weeks before inclusion
Other illness
- Other prior malignancy less than or equal to 5 years prior to randomization except for squamous or basal cell skin carcinoma or non-invasive superficial bladder cancer
- History of seizures or medications known to lower seizure threshold
Other
- Pathological finding consistent with small cell, ductal or neuroendocrine carcinoma of the prostate
Who the study is looking for
- Male and ≥18 years of age
- Capable of understanding and complying with protocol requirements and able to understand and sign the informed consent form
- Histological diagnosis of prostate adenocarcinoma
- Low volume de novo metastatic disease (M1a or M1b) defined as anything other than fitting the criteria for high-volume metastatic disease, e.g., four or more bone lesions with one or more lesions in any body structure beyond the spine or pelvis, or visceral disease (non-nodal). This has been assessed by either bone scan and computed tomography (CT), or PSMA-PET scan. Low-volume disease has subsequently been confirmed by the local (multidisciplinary) team after consideration of the available imaging results as per the standard imaging protocol for the site.
- ADT initiated within 6 weeks prior to inclusion
- Eastern Cooperative Oncology Group (ECOG) performance scale status of 0, 1 or 2
- Fit for treatment with apalutamide or enzalutamide according to treating physician
Age in the registry: 18 years to - · Sex: Male · Does not accept healthy volunteers
Sites (26)
Sites in registry order. Pick your city on the disease page to sort them by distance.
| Site | City | Country | Site status |
|---|---|---|---|
| Noordwest Ziekenhuisgroep Coordinator of this site? Confirm its status | Alkmaar | Netherlands | Recruiting |
| Meander MC Amersfoort Coordinator of this site? Confirm its status | Amersfoort | Netherlands | Not yet recruiting |
| Amsterdam Universitair Medisch Centrum Coordinator of this site? Confirm its status | Amsterdam | Netherlands | Not yet recruiting |
| Antoni van Leeuwenhoek Coordinator of this site? Confirm its status | Amsterdam | Netherlands | Not yet recruiting |
| Wilhelmina Ziekenhuis Assen Coordinator of this site? Confirm its status | Assen | Netherlands | Recruiting |
| Rode Kruis Ziekenhuis Coordinator of this site? Confirm its status | Beverwijk | Netherlands | Recruiting |
| Deventer Ziekenhuis Coordinator of this site? Confirm its status | Deventer | Netherlands | Recruiting |
| Catharina Ziekenhuis Coordinator of this site? Confirm its status | Eindhoven | Netherlands | Recruiting |
| Treant Zorggroep Coordinator of this site? Confirm its status | Emmen | Netherlands | Recruiting |
| Medisch Spectrum Twente Coordinator of this site? Confirm its status | Enschede | Netherlands | Recruiting |
| Admiraal de Ruyter Ziekenhuis Coordinator of this site? Confirm its status | Goes | Netherlands | Recruiting |
| Universitair Medisch Centrum Groningen Coordinator of this site? Confirm its status | Groningen | Netherlands | Recruiting |
| Spaarne Gasthuis Coordinator of this site? Confirm its status | Haarlem | Netherlands | Recruiting |
| Ziekenhuisgroep Twente Coordinator of this site? Confirm its status | Hengelo | Netherlands | Recruiting |
| Tergooi MC Coordinator of this site? Confirm its status | Hilversum | Netherlands | Not yet recruiting |
| Frisius MC Leeuwarden Coordinator of this site? Confirm its status | Leeuwarden | Netherlands | Recruiting |
| Maastricht UMC Coordinator of this site? Confirm its status | Maastricht | Netherlands | Recruiting |
| Canisius Wilhelmina Ziekenhuis Coordinator of this site? Confirm its status | Nijmegen | Netherlands | Recruiting |
| Laurentius Ziekenhuis Coordinator of this site? Confirm its status | Roermond | Netherlands | Recruiting |
| Bravis Ziekenhuis Coordinator of this site? Confirm its status | Roosendaal | Netherlands | Recruiting |
| Fransicus Gasthuis & Vlietland Coordinator of this site? Confirm its status | Rotterdam | Netherlands | Recruiting |
| Erasmus MC Coordinator of this site? Confirm its status | Rotterdam | Netherlands | Recruiting |
| Maasstad Ziekenhuis Coordinator of this site? Confirm its status | Rotterdam | Netherlands | Recruiting |
| HagaZiekenhuis Coordinator of this site? Confirm its status | The Hague | Netherlands | Recruiting |
| St Antonius Ziekenhuis Coordinator of this site? Confirm its status | Utrecht | Netherlands | Not yet recruiting |
| VieCuri Medisch Centrum Coordinator of this site? Confirm its status | Venlo | Netherlands | Recruiting |
This page is information, not medical advice. Discuss any trial with your doctor.