The ENHANCE Phase 3 Trial Tries to Cuts Hormone Therapy Side Effects

Hormone therapy has been a cornerstone for treating advanced prostate cancer, starving tumors of the male hormones they crave to grow. But it often brings harsh side effects like crushing fatigue, hot flashes, high blood pressure, and loss of muscle mass that make daily life a struggle for many men. Now, a major new UK trial called ENHANCE is testing whether half doses of these powerful drugs can fight cancer just as well while slashing those downsides.

Launched this month with £3.2 million from Cancer Research UK and Prostate Cancer UK, ENHANCE will enroll around 1,500 men with metastatic prostate cancer across UK hospitals. Participants get standard hormone therapy, using injections to lower testosterone, plus one of four common add-on drugs: abiraterone, enzalutamide, darolutamide, or apalutamide. Half will receive the usual full dose; the other half a reduced one, in a blinded setup where neither patients nor doctors know who’s on what.

The goal? Prove that lower doses keep cancer in check, measured by survival, PSA blood levels, and scans, without the full brunt of side effects. Researchers will track quality of life through patient surveys, treatment dropout rates, NHS costs, and even biomarkers in blood, urine, and tumor samples to spot who benefits most.

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