Jarad Martin, Senior Staff Specialist of Department of Radiation Oncology at Calvary Mater Hospital, shared on LinkedIn:
“Great to see the ENZARAD manuscript out! Although overall a negative trial, having accrued and followed a bunch of participants for a decade, I’ve formed a few end-user thoughts on Enzalutamide as a ARI treatment intensification strategy for high risk patients in the non-metastatic setting with ADT and radiotherapy for prostate cancer.
- ARIs aren’t for all high risk patients. Hint of a benefit for pelvic node positives on conventional imaging, but overall effect probably diluted by lower risk participants like Gleason 8s
- Adjuvant Enzalutamide can be tricky to give. It is harder to motivate participants to put up with the fatigue, and tough to dose reduce when you can’t titrate to PSA control like you can in the relapse/metastatic settings.
- Outcomes with modern RT are pretty good. You know what they say about cross-trial comparisons… but compared with the PROTEUS approach of ADT and Apalutamide in the perioperative setting, PSA control of ~ 20% at 4yr verses ~65% at 8yr on ENZARAD. Makes sense to me due to the synergy between RT and androgen receptor modulation for DNA repair.
- And then there’s DASL-HiCaP. Similar baseline therapies, but higher risk patients managed with adjuvant Darolutamide, showing MFS HR of 0.42 (!). Manuscript hopefully landing soon.”
Title: ENZARAD (ANZUP 1303): Phase 3 Trial of Enzalutamide With Androgen Deprivation Therapy and Radiation Therapy in High-Risk Localized or Locally Advanced Prostate Cancer
Authors: Scott Williams, Christopher J. Sweeney, Hayley Thomas, Blossom Mak, Alison Zhang, Tee Sin Lim, Chakiath Jose, Jarad Martin, Nitya Patanjali, David Pryor, Phuong Tran, Stephen Mangar, Alina M. Mihai, Carys Thomas, Simon Gampenrieder, Sonia Yip, Leanna Cheung, Sandra Lee, Annabelle Goodwin, Annette Haworth, Anna Walsh, Paul J. Kelly, Simon Hughes, Andrew Martin, Ray McDermott, Martin Stockler, Ian D. Davis, Paul L. Nguyen
You can also read:
DASL-HiCaP at ESMO 2026: Darolutamide Plus ADT and Radiotherapy in Very High-Risk Prostate Cancer
