A randomised clinical trial aiming to improve survival in advanced prostate cancer by adapting treatment
with a personalized dosing strategy has enrolled its first participants.
ANZadapt is a unique collaboration between two research groups from different continents: the Australian
and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP) and the Leiden University Medical
Center (LUMC) in the Netherlands. The teams were brought together and supported by the Anticancer
Fund (ACF), a non-profit research organisation committed to improving outcomes for cancer patients.
ANZadapt is testing an innovative approach to treatment for people with castration-resistant prostate
cancer (CRPC), which remains one of the most common causes of cancer-related death worldwide. The trial
will test the idea of evolutionary therapy, also known as adaptive therapy. This will lead to a personalized
treatment schedule, different for each participant.
Using approved hormone tablets for prostate cancer, abiraterone or enzalutamide, treatment will be given
sparingly, for just long enough to control the cancer, followed by a break in treatment, then restarting the
tablets later, aiming to improve the overall period of time that the hormone tablets can control the cancer.
ANZadapt aims to prove if this adaptive strategy is better than the usual advice of taking the hormone
tablets every day continuously.
Pilot studies of adaptive therapy, including an ANZUP-supported pilot study led by Australian principal
investigator Assoc. Prof Craig Gedye, have suggested that pausing therapy when the cancer is stable, rather
than continuous treatment that drives cancer cells to evolve, may prolong the benefit of treatment likely
by delaying the emergence of treatment-resistant cancer cells.
The first participants enrolled marks the start of a journey to recruit and follow-up 168 eligible patients
across Australia and the Netherlands. By collaborating across continents and aligning trial processes and
protocols, ANZadapt has the potential to enroll and report quickly, and may lead to radical changes in
treatment for people with prostate cancer.
“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.
“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 Dr Gauthier Bouche, Director of Clinical Research of the Anticancer Fund.
“The ANZadapt study may become a ground-breaking study in the field of oncology. If 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 Dr Tom van der Hulle and Dr Dirk-Jan Moes, the principal investigators of the
ANZadapt study in The Netherlands.
About ANZUP
ANZUP is the leading Australasian cancer-cooperative clinical trials group that brings together all of the
professional disciplines and groups involved in researching and treating urogenital cancers and conducting
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. ANZUP receives valuable infrastructure support from the Australian Government
through Cancer Australia.
About 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 personalize oncological treatment, reduce side effects and toxicity and improve
cost-effectiveness.
About the Anticancer Fund
The Anticancer Fund is a Belgian research organization with an international scope, aimed at bringing more
and better treatments to people with cancer. Financial return is not our goal when we support clinical
studies, the benefit must be for the patient. We want people with cancer to live longer, with the best
quality of life possible.
People with cancer, and their relatives, can reach out to My Cancer Navigator, a service offered by the
Anticancer Fund, for information about cancer and about treatment options. This service is also available
to health care professionals who are looking for evidence-based information on cancer treatments.
Beyond our work in cancer research and cancer care, we address governments and decision-makers,
especially on European level. We engage in policy discussions to ensure that a true benefit for the patient is
the greatest priority in cancer-related decisions and legislation.
The Anticancer Fund depends on private donations