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Prostate CancerPhase 2WOMBATNCT06594926

Working Out M0 Bipolar Androgen Therapy

A Phase 2 study testing Testosterone Enanthate in people with Prostate Cancer, run by Australian and New Zealand Urogenital and Prostate Cancer Trials Group at 12 sites in Australia.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The WOMBAT study will test if BAT can prolong the time it takes for nmCRPC prostate cancer to become detectable in other areas of the body (metastatic disease). Approximately 69 participants over the age of 18 with castrate resistant prostate cancer, no evidence of metastatic disease (M0) on conventional imaging (WBBS… Read more about this study

Who is it for?
Ages 18 years and older, men only
Conditions the study is for
Prostate Cancer
What is being tested?
Testosterone Enanthate
Could I receive a placebo?
No, everyone receives an active treatment
How many people
69 participants
Where
12 sitesAustralia
Study dates
14 Aug 2024to 31 Dec 2028
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically confirmed adenocarcinoma of the prostate
  • ≥18 years of age
  • ECOG performance status 0-1
  • PSA progression while on darolutamide defined as three rising PSA (1 baseline and 2 consecutive rises) levels at least 1 week apart despite castrate testosterone level (<1.7nmol/L). Patients with a minor subsequent PSA fall, provided there was no intervening therapy since the three consecutive rises, are eligible
  • AJCC stage M0 on conventional imaging.
  • Previous PSMA PET only M1 disease in the hormone-sensitive setting that is now M0 CRPC on conventional imaging following >18 months of ADT + darolutamide are eligible.
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  • Nodes up to 2cm in short-axis in pelvis are permitted
  • PSA >1.0 ng/mL during screening
  • Serum testosterone <1.7nmol/L and on an LHRH agonist/antagonist
  • Adequate bone marrow function (platelets > 100 x 109/L, ANC > 1.5 x 109/L, Hb >90)
  • Adequate liver function (ALT or AST < 2.5 x ULN, bilirubin < 1.5 x ULN)
  • Adequate renal function (creatinine <1.5 x ULN)
  • Willingness and ability to comply with study requirements, including treatment and timing of treatment.

Who cannot join

  • Life expectancy <3 months.
  • Neuroendocrine or small cell prostate cancer on any prior diagnostic tissue sample.
  • Metastatic prostate cancer on conventional imaging (WBBS or CT scan) at any point in disease course (except for pathological nodes up to 2cm in short axis in the pelvis).
  • Current or prior treatment with enzalutamide, abiraterone, apalutamide, or cytotoxic chemotherapy. Patients with pelvic nodal metastases (below the aortic bifurcation) <2cm in short axis at original diagnosis who ceased cytotoxic chemotherapy (docetaxel) at least 12 months prior to C1D1 are eligible. Prior first generation ARSI such as bicalutamide, flutamide, nilutamide are permitted.
  • Current or pre-existing cardiac or thromboembolic risk factors, including but not limited to:
  • Prior myocardial infarction, or unstable angina within 24 months of study entry, ii. Uncontrolled or symptomatic cardiac disease including, but not limited to angina, dyspnoea on exertion, orthopnoea; cardiac failure (NYHA classification 3-4) or uncontrolled arrhythmias.
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  • Significant co-morbidities that increase cardiovascular risk, including significant hypertension (Baseline systolic BP>160 or diastolic BP>100 despite optimal treatment) that are uncontrolled, as assessed by the treating oncologist.
  • Another malignancy diagnosis within 2 years before registration. Participants with a history of treated carcinoma in situ, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or non-muscle invasive urothelial carcinoma of the bladder are eligible if malignancy has been treated with curative intent. Participants with a history of other malignancies are eligible if they have been continuously disease-free for at least 2 years after definitive primary treatment or the chance of recurrence is sufficiently low as to be very unlikely to affect study outcomes according to the treating local oncologist.
  • Concurrent illness that could preclude the participant's ability to participate in the study and follow protocol with reasonable safety.
  • Planned ongoing drug Interactions as per protocol section 5.2.4 that are considered unable to be managed prior to study registration.
  • Radiation therapy within the previous 4 weeks (participants are permitted to have SBRT to PSMA PET only disease prior to study enrolment if they continue on darolutamide. Note that if the metastases are visible on conventional imaging at the time of radiation treatment the participant is not eligible).

Trial locations and contacts

12 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Antoinette Fontela, BSc contact

+61 2 9046 8954

Trials@anzup.org.au

Jennifer Thompson, BSc contact

jennifer.thompson@anzup.org.au

12 sites in 1 country

Australia12 sites, 11 recruiting
  • Royal Adelaide Hospital

    Adelaide, South Australia, 5000

    Sonya Stephens, sonya.stephens@sa.gov.au

    Thean Hsiang Tan

    Recruiting
  • The Border Cancer Hospital

    Albury, New South Wales, 2640

    Terminated
  • Grampians Health

    Ballarat, Victoria, 3350

    Belinda Mende, Belinda.Mende@gh.org.au

    Sharad Sharma

    Recruiting
  • Eastern Health - Box Hill

    Box Hill, Victoria, 3128

    Sue Cranmer, 0390949529, sue.cranmer@monash.edu

    Karen Lim, 0390949529, karen.lim@monash.edu

    Recruiting
  • ICON Cancer Centre

    Chermside, Queensland, 4032

    Jesse Peet, jesse.peet@icon.team

    Jeffrey Goh

    Recruiting
  • St Vincents Hospital

    Darlinghurst, New South Wales, 2010

    Angelina Lay, angelina.lay@svha.org.au

    Anthony Joshua, MBBS FRACP

    Recruiting
  • The Canberra Hospital

    Garran, Australian Capital Territory, 2605

    Monika Tencic, +61251244102, monika.tencic@act.gov.au

    Olga Krepysheva, +6125124 3688, olga.krepysheva@act.gov.au

    Recruiting
  • Cabrini Health

    Malvern, Victoria, 3144

    Dina Cherfi, DCherfi@cabrini.com.au

    David Pook

    Recruiting
  • Mater Misericordiae Ltd - QLD

    South Brisbane, Queensland, 4101

    Claire Jackson, +6173163 6342, Claire.Jackson1@mater.org.au

    Dan Krytskyi, +6273163 6313, dan.krytskyi@mater.org.au

    Recruiting
  • GenesisCare North Shore

    St Leonards, New South Wales, 2065

    Suzi Jakicic, Suzi.Jakicic@genesiscare.com

    Laurence Krieger

    Recruiting
  • Sydney Adventist Hospital

    Wahroonga, New South Wales, 2076

    Gloria Jeong, 029480 6285, gloria.jeong@sah.org.au

    Gavin Marx

    Recruiting
  • Northeast Health Wangaratta

    Wangaratta, Victoria, 3677

    Nicole Humphreys, +6135722 5521, nicole.humphreys@nhw.org.au

    Kay Xu

    Recruiting

Other trials in Australia

About this study

Official title: Evaluating the Efficacy of Bipolar Androgen Therapy in Extending Metastasis-free Survival in Patients With M0 Castrate-resistant Prostate Cancer With PSA Progression But Not Radiological or Clinical Progression on Darolutamide

The WOMBAT study will test if BAT can prolong the time it takes for nmCRPC prostate cancer to become detectable in other areas of the body (metastatic disease).

Approximately 69 participants over the age of 18 with castrate resistant prostate cancer, no evidence of metastatic disease (M0) on conventional imaging (WBBS and CT scan at screening) and PSA only progression on darolutamide will be enrolled from approximately 8 sites within Australia.

Read more

Participants will receive continuous androgen deprivation therapy with LHRH agonists/antagonists. The study intervention will be IM testosterone enthanate, injected on day 1 of each 56-day cycle. Concurrent darolutamide will be taken at a dose of 600mg BD on days 29-56 of each cycle. Both LHRH and agonist/antagonist and darolutamide are supplied through the PBS as standard of care medications. Administration of both testosterone and darolutamide will continue until disease progression, beyond disease progression, unacceptable toxicity, death, withdrawal of consent or study Sponsor termination of the study.

Primary objective (endpoint) is to determine the metastasis-free survival (time from commencing BAT to evidence of metastases or death)

Read the detailed description

This is a study to assess the efficacy and safety of cyclical testosterone and darolutamide in non-metastatic castration-resistant prostate cancer.

Adults with castrate resistant prostate cancer, with no evidence of metastatic disease (M0) on conventional imaging [Whole Body Bone Scan (WBBS) and Computed Tomography (CT) scan at screening] and prostate specific antigen (PSA) only progression on darolutamide may be eligible.

Study participants will receive cyclical treatment with intramuscular (IM) testosterone, darolutamide and ongoing medical/surgical castration. This will be delivered in 56-day cycles until evidence of metastatic disease on conventional imaging unless treated beyond progression. Participants will be asked to provide blood samples, complete questionnaires and undergo scans during their treatment.

It is hoped that findings from this study will help develop new treatment pathways for those with non-metastatic castration-resistant prostate cancer.

Conditions
Prostate Cancer
Being tested
Testosterone Enanthate
Keywords
darolutamide, testosterone, bipolar androgen therapy
Medical subject headings
Prostatic Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Testosterone EnanthateDrug

    Also called Primoteston Depot

    Testosterone enanthate is a depot formulation used in Australia typically for androgen replacement in people with confirmed testosterone deficiency.

Study groups in NCT06594926
Study groupRoleWhat they receive
Testosterone enthanateExperimentalParticipants will receive continuous androgen deprivation therapy with LHRH agonists/antagonists. The study intervention will be IM testosterone enthanate, injected on day 1 of each 56-day cycle (+3 days) except for cycle 1. Concurrent darolutamide will be taken at a dose of 600mg BD on days 29-56 of each cycle. Both LHRH and agonist/antagonist and darolutamide are supplied through the PBS as standard of care medications.
Receives: Drug: Testosterone Enanthate

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Metastases free survival

    Based on PCWG3 criteria (appendix 2) and/or RECIST1.1 (appendix 1) on CT and WBBS imaging.

    Measured: From date of commencing Bipolar Androgen Therapy (BAT) until first documented evidence of metastatic disease or date of death, assessed every 8 weeks, on average 4 years

Secondary outcomes (7)
  1. Safety and tolerability of BAT + darolutamide

    The safety and tolerability of BAT + darolutamide (Incidence and grade of AEs by NCI CTCAE v5.0 Common Terminology Criteria for Adverse Events will be used to grade and classify adverse events after each cycle. Adverse events will be reported as all grade, grade 3-4, grade 5 and Adverse events of special interest (related to bipolar androgen therapy).

    Measured: Continuously throughout the study, from time of commencing BAT until 30 days after last dose of treatment

  2. The effect of BAT + darolutamide on Health-related Quality of Life QLQ-C30

    Using the European Organisation for Research Treatment of Cancer (EORTC) quality of life (QOL) questionnaire QLQ-C30. QLQ-C30 uses 28 questions about overall QOL with each question answerable using a scale from 1 (not at all) to 4 (very much). Overall scores can be from a minimum of 28 indicating a better QOL and higher scores with a maximum of 112 indicating lower overall QOL. It has two summary questions which asks participants to rank, 1) overall health and 2) overall QOL on scale from 1: very poor, to 7; excellent.

    Measured: During screening and then every 2 weeks upon commencement of BAT for 8 weeks and then every 4 weeks until last dose of treatment, on average 2 years.

  3. The effect of BAT + darolutamide on Health-related Quality of Life QLQ-PR25

    Using the European Organisation for Research Treatment of Cancer (EORTC) quality of life (QOL) questionnaire QLQ-PR25. QLQ-PR25 is a supplement to QLQ-C30 and designed to assess symptoms related to prostate cancer, treatment, and aspects of life related to prostate cancer.QLQ-PR25 uses 25 questions about overall QOL with each question answerable using a scale from 1 (not at all) to 4 (very much). Overall scores can be from a minimum of 25 indicating a better QOL and higher scores with a maximum of 100 indicating lower overall QOL.

    Measured: During screening and then every 2 weeks upon commencement of BAT for 8 weeks and then every 4 weeks until last dose of treatment, on average 2 years.

  4. PSA response rate to BAT + darolutamide

    By testing PSA level in blood. PSA response rate is defined as a PSA reduction of >=50% from baseline as per PCWG3 criteria

    Measured: During screening and then every 2 weeks from the time of commencing BAT for first 8 weeks and then every 4 weeks until last dose of treatment, on average 2 years

  5. Time to PSA progression on BAT + darolutamide

    By testing PSA level in blood. PSA progression is defined as a PSA increase of >=25% from baseline or nadir, confirmed on subsequent test >=1 week later as per PCWG3)

    Measured: During screening and then every 2 weeks from the time of commencing BAT for first 8 weeks and then every 4 weeks until last dose of treatment, on average 2 years

  6. PSA and hormone kinetics in response to BAT + darolutamide. This will be assessed as a composite outcome.

    Blood tests assessing change in PSA, testosterone, oestradiol, Dihydrotestosterone (DHT), Dehydroepiandrosterone (DHEA), sex hormone-binding globulin (SBHG)

    Measured: Every 2 weeks for first 24 weeks from the time of commencing BAT

  7. The effect of BAT + darolutamide on metabolic and bone turnover markers and bone mineral density. This will be assessed as a composite outcome.

    Testing bone turnover markers via serum procollagen type I N propeptide (PINP) and plasma C-terminal cross-linking telopeptide of type I collagen (CTX). Bone densitometry imaging.

    Measured: Serum/plasma/urine - at screening and at 6 and 12 months on treatment. Bone densitometry imaging - at screening and 12 months on treatment.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Sep 2024
  2. Study start14 Aug 2024
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
This is a single-arm phase 2 prospective, interventional study to assess the efficacy and safety of cyclical testosterone and darolutamide in non-metastatic castration-resistant prostate cancer.
Masking
None (open label)
Enrolment
69 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06594926
Sponsor's protocol ID
ANZUP 2201
Acronym
WOMBAT
Status last verified
Apr 2026
First submitted
23 May 2024
Last updated
24 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Talmor B, Harris CA, Gianacas C, Pook D, Tan TH, Davis ID, Krieger L, Marx G, Anton A, Sharma S, Goh JC, Xu K, Pranavan G, Dhillon HM, Antonarakis ES, Denmeade SR, Horvath L, Oakes SR, Allen R, Fontela A, Reich E, Crumbaker M, Hurwitz J, Joshua AM. WOMBAT (ANZUP 2201): A Phase 2, Single-arm Study of Bipolar Androgen Therapy in Patients with Nonmetastatic Castration-resistant Prostate Cancer with Prostate-specific Antigen Progression on Darolutamide. Eur Urol Oncol. 2026 Apr;9(2):472-478. doi: 10.1016/j.euo.2026.02.004. Epub 2026 Feb 21.

    PubMed 41724634

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Testosterone Enanthate in people with Prostate Cancer, run by Australian and New Zealand Urogenital and Prostate Cancer Trials Group at 12 sites in Australia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 13 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 24 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in Australia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Antoinette Fontela, BSc (+61 2 9046 8954, Trials@anzup.org.au), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Metastases free survival (time frame: From date of commencing Bipolar Androgen Therapy (BAT) until first documented evidence of metastatic disease or date of death, assessed every 8 weeks, on average 4 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06594926, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Apr 2026.

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Working Out M0 Bipolar Androgen Therapy (NCT06594926) | AzTrials