Evaluating Hormone Therapy to Achieve Optimal Doses in Metastatic Prostate Cancer

ENHANCE is a clinical trial in patients with newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC) or castration-resistant prostate cancer (mCRPC) who are clinically suitable for and planned to commence Androgen Receptor Pathway Inhibitors (ARPI) plus standard Androgen Deprivation Therapy (ADT). Participants will be randomised according to the trial's stratification criteria to receive standard recommended (100%) dose or reduced dose (50%) of ARPI (enzalutamide, apalutamide, darolutamide or abiraterone) and take ADT. Participants will have hospital clinic visits according to the trial visits assessment schedule as detailed in the trial protocol and in line with the recruiting centers standard of care policy. Participants will complete questionnaires and keep a symptoms diary in accordance with the assessments schedule. Participants will provide urine, blood and tumour diagnostic biopsy samples for translational research purposes according to the assessments schedule which will be sent to and processed by a Central Laboratory located in Manchester.