Radiographic Progression Without Prostate-specific Antigen Progression in Metastatic Hormone-sensitive Prostate Cancer: A Retrospective Analysis of the ENZAMET Trial (ANZUP 1304)
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Date
2026
Authors
Inderjeeth, A.-J.
Martin, A.J.
Zielinski, R.R.
Begbie, S.
Cheung, L.
Chowdhury, S.
Frydenberg, M.
Horvath, L.G.
Joshua, A.M.
Lawrence, N.J.
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European Urology Oncology, 2026; 1-8
Statement of Responsibility
Andrisha-Jade Inderjeeth, Andrew J. Martin, Robert R. Zielinski, Stephen Begbie, Leanna Cheung, Simon Chowdhury, Mark Frydenberg, Lisa G. Horvath, Anthony M. Joshua, Nicola J. Lawrence, Gavin Marx, John McCaffrey, Raymond S. McDermott, Margaret McJannett, Scott A. North, Francis Parnis, Wendy R. Parulekar, David W. Pook, Martin N. Reaume, Shahneen Sandhu, Alvin Tan, Thean H. Tan, Alastair H. Thomson, Francisco Vera-Badillo, Scott G. Williams u, Hayley Thomas f, Sonia Yip f, Alison Y. Zhang f, Kim N. Chi z, Martin R. Stockler aa, Christopher J. Sweeney, Ian D. Davis, for the ENZAMET Trial Investigators and the Australian and New Zealand Urogenital and Prostate Cancer Trials Group
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Abstract
Background and objective ENZAMET randomised 1125 participants with metastatic hormone-sensitive prostate cancer to receive enzalutamide or a standard nonsteroidal antiandrogen (NSAA) combined with testosterone suppression with or without docetaxel. Enzalutamide demonstrated superior progression-free and overall survival (OS). Radiographic progression without prior/concurrent prostate-specific antigen progression (discordant progression; DP) portends poor outcomes. Our aim was to determine the frequency of DP in ENZAMET and the impact of enzalutamide on disease-state transitions. Methods A multistate Cox proportional-hazards regression model was used to partition participants into four states: (1) event-free; (2) discordant progression (DP); (3) other types of progression (other progression; OP); and (4) death.
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©2026 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).