New findings of the ENZAMET study, led by the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP), reveal that people who inherit a genetic biomarker known to predict poorer outcomes with routine prostate cancer treatment could be successfully treated and have better survival outcomes with personalised hormonal therapy.
Professor Ian Davis, medical oncologist and Professor of Medicine at Monash University and Eastern Health, said, “Prostate cancer is a complex disease, and we need to personalise treatments for our patients to get the best outcomes. The ENZAMET (ANZUP 1304) trial has given us clues about how best to do this based on certain genetic tests, allowing more effective treatment that improves outcomes for people who otherwise might not have done so well.”
The large clinical trial investigated a gene called the 'adrenal-permissive HSD3B1 allele', found in around 50 per cent of people, and linked to poorer survival in prostate cancer.
ENZAMET (ANZUP 1304) showed that treatment with Astellas' XTANDI (enzalutamide) could overcome the poorer outcomes these people would otherwise have experienced.
The treatment reduces the risk of dying of prostate cancer, with 67 per cent of patients receiving XTANDI still alive after five years compared to 57 per cent of those receiving standard treatment.
Dr Nima Sharifi, medical oncologist and physician-scientist at the University of Miami, Desai Sethi Urology Institute and Sylvester Comprehensive Cancer Center, said, “We have been studying how this gene drives prostate cancer for over a decade. When we look at the statistics, 50 per cent of people that have this inherited androgen-driving gene are faced with a poor prognosis and with limited treatment options. Our findings show that these poor outcomes can be successfully reversed with specific treatment.”
“This is a very positive step forward in the understanding of advanced prostate cancer at a clinical level. We need to continue to implement these findings to better focus clinical trials in future so we can develop more targeted and effective therapies that best treat advanced prostate cancer to reduce mortality and improve survival. I am so delighted to work together with ANZUP on this study.”
Prostate cancer is the most diagnosed cancer in Australian men and across the Australian population overall. It is estimated that 26,400 prostate cancer cases will be diagnosed, and 3,900 deaths will be recorded in 2024 alone. By 2040, there will be 372,000 men living with prostate cancer in Australia, representing the greatest number of men or women diagnosed with any single cancer.
ANZUP CEO, Associate Professor Samantha Oakes says, “Our mission at ANZUP is to improve the lives of people affected by Below the Belt cancers through practice-changing multidisciplinary collaborative clinical trials. With 54 new diagnoses every day, prostate cancer is a major focus. The discoveries through the ENZAMET(ANZUP 1304) study continue to pave the way for more effective therapies that can improve survival outcomes for people with advanced prostate cancer.”
