New combination therapy improves survival rates for Aussies with advanced prostate cancer

A world-first treatment approach has demonstrated significant advancements in the management of metastatic castration-resistant prostate cancer (mCRPC) compared to conventional therapies. The ENZA-p study, led by the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP), investigated the efficacy of Novartis’ Pluvicto (LuPSMA) combined with Xtandi (enzalutamide) versus Xtandi alone.

The study not only revealed improved overall survival but also enhanced quality of life outcomes through an innovative ‘adaptive dosing’ strategy. This approach utilises imaging and blood markers to tailor treatment, optimising outcomes for individual patients.

Professor Louise Emmett, ENZA-p Study Chair and Director of Theranostics and Nuclear Medicine at St Vincent’s Hospital Sydney, highlighted the study’s findings, saying “Our research underscores that patients receiving the combination therapy experienced extended survival and significant improvements in pain and fatigue, particularly for those with a poorer prognosis. The study opens the door for exploring this combination of treatments earlier in metastatic prostate cancer.”

The study, presented today the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium, reported a significant increase in overall survival among patients receiving the combination treatment compared to those on Astellas-Pfizer’s Xtandi alone (median months 34 vs 26; p=0.005). Furthermore, patients receiving Pluvicto (currently not reimbursed) with Xtandi saw a 27% improvement in overall health and quality of life (OHQL) compared to those on Xtandi alone (40% vs 13%; p <0.001).

Prostate cancer remains the most commonly diagnosed cancer in Australia, with projections indicating a significant rise in cases by 2040.

Samantha Oakes, CEO of ANZUP, emphasised the organisation’s commitment to advancing treatment options for ‘Below the Belt’ cancers. She stated, “Since our inception in 2008, ANZUP has funded 33 Below the Belt cancer trials across 772 global sites providing over 8,000 participants access to innovative clinical trials.​

“We are proud to showcase our Australian-led first-of-its-kind research on an international stage. The discoveries through the ENZA-p study will pave the way for more effective combination therapies that can improve survival outcomes and revolutionise care for people with advanced prostate cancer with poor prognosis.”

The collaborative efforts of ANZUP, the NHMRC Clinical Trials Centre at the University of Sydney, and the Australasian Radiopharmaceutical Trials Network have been instrumental in driving this landmark research. The study was funded by the Prostate Cancer Research Alliance (PCRA), a joint initiative supported by the Australian Government and Movember.

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