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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
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

Full criteria on ClinicalTrials.gov

Sites (26)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
Noordwest Ziekenhuisgroep
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AlkmaarNetherlandsRecruiting
Meander MC Amersfoort
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AmersfoortNetherlandsNot yet recruiting
Amsterdam Universitair Medisch Centrum
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AmsterdamNetherlandsNot yet recruiting
Antoni van Leeuwenhoek
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AmsterdamNetherlandsNot yet recruiting
Wilhelmina Ziekenhuis Assen
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AssenNetherlandsRecruiting
Rode Kruis Ziekenhuis
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BeverwijkNetherlandsRecruiting
Deventer Ziekenhuis
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DeventerNetherlandsRecruiting
Catharina Ziekenhuis
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EindhovenNetherlandsRecruiting
Treant Zorggroep
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EmmenNetherlandsRecruiting
Medisch Spectrum Twente
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EnschedeNetherlandsRecruiting
Admiraal de Ruyter Ziekenhuis
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GoesNetherlandsRecruiting
Universitair Medisch Centrum Groningen
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GroningenNetherlandsRecruiting
Spaarne Gasthuis
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HaarlemNetherlandsRecruiting
Ziekenhuisgroep Twente
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HengeloNetherlandsRecruiting
Tergooi MC
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HilversumNetherlandsNot yet recruiting
Frisius MC Leeuwarden
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LeeuwardenNetherlandsRecruiting
Maastricht UMC
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MaastrichtNetherlandsRecruiting
Canisius Wilhelmina Ziekenhuis
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NijmegenNetherlandsRecruiting
Laurentius Ziekenhuis
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RoermondNetherlandsRecruiting
Bravis Ziekenhuis
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RoosendaalNetherlandsRecruiting
Fransicus Gasthuis & Vlietland
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RotterdamNetherlandsRecruiting
Erasmus MC
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RotterdamNetherlandsRecruiting
Maasstad Ziekenhuis
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RotterdamNetherlandsRecruiting
HagaZiekenhuis
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The HagueNetherlandsRecruiting
St Antonius Ziekenhuis
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UtrechtNetherlandsNot yet recruiting
VieCuri Medisch Centrum
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VenloNetherlandsRecruiting

This page is information, not medical advice. Discuss any trial with your doctor.