ENHANCE
Research type
Research Study
Full title
Evaluating Hormone Therapy to Achieve Optimal Dosing in Metastatic Prostate Cancer
IRAS ID
1011482
Contact name
Nick McNally
Contact email
Sponsor organisation
University College London
Research summary
There are about 52,000 new cases of prostate cancer in the UK each year. Hormone therapy in the form of androgen deprivation therapy (ADT), and androgen receptor pathway inhibitors (ARPIs) is used when the cancer has spread. Drugs like enzalutamide, abiraterone, darolutamide and apalutamide, known as ARPIs help block male hormones that promote cancer growth, and they’ve been shown to help patients live longer when added to standard hormone therapy (ADT). NICE recommends enzalutamide, apalutamide, abiraterone and darolutamide for treating advanced prostate cancer. Evidence suggests that these drugs could work just as well at lower doses, which would reduce side effects, improve quality of life and lower costs.
ENHANCE is a Phase III, randomised clinical trial. Participants will be given standard ADT, and either full-dose or half-dose ARPI. to see if the same benefits can be achieved, but with fewer side effects and better quality of life, especially fatigue which is a common issue experienced by patients. The study will involve 1,500 men across 25 UK hospitals. By making treatment more tolerable, it is expected that more men may stay on treatment, and therefore potentially improve survival as well. The trial will involve 1,500 men across multiple UK hospitals. The main risk to participants is the potential decrease in survival time with a lower dose, however, this will be monitored closely. All participants will attend their local hospital as they would if they were receiving normal treatment for prostate cancer and will have the same tests as standard to monitor their health. We plan to ask for the biopsy tissue and take five extra blood and three extra urine samples during the trial to look for biomarkers that might tell us whether there are subsets of men who may not benefit from lower drug doses.
ENHANCE represents a trial concept driven by patients. In close collaboration with patient and public involvement members, who have helped design the research.REC name
South Central - Oxford B Research Ethics Committee
REC reference
26/SC/0076
Date of REC Opinion
10 Apr 2026
REC opinion
Further Information Favourable Opinion