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This treatment regimen consists of androgen deprivation therapy (ADT) in combination with an androgen receptor pathway inhibitor (ARPI), specifically either apalutamide or enzalutamide. It is currently being investigated in the 'Apa/Enza Short Study,' a randomized Phase 3 investigator-initiated trial led by Dr. Nick Beije at Erasmus MC in the Netherlands. The study evaluates whether a shortened 12-month duration of ARPI therapy is non-inferior to continuous therapy in patients with low-volume metastatic castration-sensitive prostate cancer (mCSPC). ADT works by reducing circulating testosterone levels (typically through GnRH receptor modulation), while ARPIs like apalutamide and enzalutamide are small molecules that competitively inhibit the androgen receptor, blocking nuclear translocation and DNA binding, thereby inhibiting the growth of androgen-sensitive prostate cancer cells.
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