New adaptive therapy aims to outsmart prostate cancer

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Histologically or cytologically confirmed adenocarcinoma of the prostate. * \>75% prostate specific antigen (PSA) decline after 12 to 16 weeks of run in period with Gonadotropin-releasing Hormone (GnRH) analog abiraterone plus prednisone. * Performance status Eastern Cooperative Oncology Group (ECOG) 0-1 * Adequate organ function Serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) must be \< 2.5 x upper limit of normal (ULN), total bilirubin less than 1.5 X ULN, estimated creatinine clearance must be \>40 mL/min, absolute neutrophil count (ANC) \> 1500/l, hemoglobin above 9 g/dl, platelet count \> 100,000/l * Stable medical condition, including the absence of acute exacerbations of chronic illnesses, serious infections or major surgery within 28 days prior to study enrollment * Ability to give written informed consent Exclusion Criteria: * Prior GnRH analog with GnRH analogue for non-metastatic prostate cancer within 12 months prior to study enrollment or \>3 months of GnRH analog in the metastatic setting * Prior treatments with TAK-700/Orteronel, ketoconazole, apalutamide or enzalutamide. * Documented central nervous system metastases or liver metastasis * Prior surgical castration * Requiring opioids for cancer related pain. * Treatment with any investigational compound within 30 days prior to the first dose of study drugs * Diagnosis or treatment for another systemic malignancy within 2 years before the first dose of study drugs, or previously diagnosed with another malignancy \& have any evidence of residual disease. Patients with non-melanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection. * Uncontrolled hypertension despite appropriate medical therapy (blood pressure of greater than 160 mmHg systolic and 90 mmHg diastolic at 2 separate measurements no more than 60 minutes apart during the Screening period). Note: Patients may be rescreened after adjustments of antihypertensive medications * Unstable symptomatic ischemic heart disease, ongoing arrhythmias of Grade \> 2 (NCI CTCAE, version 5), New York Association Class III or IV heart failure * Known human immunodeficiency virus (HIV) infection, active chronic hepatitis B or C not contained with anti-viral therapy, life threatening illness unrelated to cancer, or any serious medical or psychiatric illness that could, in investigator's opinion, potentially interfere with participation in this study. * Known gastrointestinal (GI) disease or GI procedure that could interfere with the GI absorption or tolerance of study drugs, including difficulty swallowing tables. * Delayed healing of wounds, ulcers, and/or bone fractures * Inability to comply with protocol requirements