Metastasis-directed Therapy for Oligorecurrent Prostate Cancer

About This Trial

This clinical trial is testing whether adding short-term hormone-blocking medication to targeted treatments, such as focused radiation, can help stop prostate cancer from spreading further.
It is for adults whose prostate cancer has returned in just a few spots—specifically, five or fewer locations outside the brain—and whose cancer still responds to hormone treatments.
Participants will receive targeted therapy directly to these tumor spots along with either one or six months of hormone therapy.
Before taking part, you should know that you must use reliable birth control during the study and cannot participate if you have widespread cancer, a history of seizures, or recent serious heart conditions.

More Information

The aim is to investigate whether the addition of short-term androgen deprivation therapy (ADT) during 1 month or short-term ADT during 6 months together with an androgen receptor targeted therapy (ARTA) to metastasis-directed therapy (MDT) significantly prolongs poly-metastatic free survival (PMFS) and/or metastatic castration-refractory prostate cancer free survival (mCRPC-FS) in patients with oligorecurrent hormone sensitive prostate cancer.

Who Can Enroll

Age Range: 18 years and older
Gender: Male
Who This Trial is For: This clinical trial is testing whether adding short-term hormone-blocking medication to targeted treatments, such as focused radiation, can help stop prostate cancer from spreading further.

Study Details

Start Date: April 20, 2022
Lead Sponsor: Universitaire Ziekenhuizen KU Leuven

Full Eligibility Criteria

Inclusion Criteria

Histologically proven initial diagnosis of prostate adenocarcinoma
Priory treated and controlled primary tumor
Biochemical recurrence defined by prostate-specific antigen (PSA) values >0,2 ng/ml (i.e., two consecutive increases) following radical prostatectomy + postoperative radiotherapy and a PSA value of 2 ng/ml above the nadir after high-dose RT.
Oligorecurrent disease defined as a maximum of 5 extracranial metastases in any organ, diagnosed on PSMA PET-CT or PSMA PET-MRI reported according to the E-PSMA consensus guidelines for interpretation of PSMA-PET (26). Nodal (N1) disease can be included only when accompanied by M1a-c disease, provided that the total number of spots does not exceed 5.
Serum testosterone level within normal range.
WHO performance 0-2
Age >= 18 years old
Absence of psychological, sociological or geographical condition potentially hampering compliance with study protocol.
Patients must be presented at the multidisciplinary board meeting and the inclusion in the trial needs approval by this board.
Voluntary written informed consent of the participant or their legally authorized representative has been obtained prior to any screening procedures
2. Use of highly effective methods of birth control; defined as those that, alone or in combination, result in low failure rate (i.e., less than 1% per year) when used consistently and correctly; such as implants, injectables, combined oral contraceptives, some IUDs, true sexual abstinence (i.e. refraining from heterosexual intercourse during the entire period of risk associated with the Trial treatment(s)) or commitment to a vasectomised partner.

Exclusion Criteria

Any disorder, which in the Investigator's opinion might jeopardise the participant's safety or compliance with the protocol
Any prior or concomitant treatment(s) that might jeopardise the participant's safety or that would compromise the integrity of the Trial
Participation in an interventional Trial with an investigational medicinal product (IMP) or device
Serum testosterone level at castration level.
PSA rise while on active treatment (LHRH-agonist, LHRH antagonist, anti-androgen, maximal androgen blockade, oestrogen)
Presence of poly-metastatic disease, defined as more than 5 metastatic lesions.
Active malignancy other than prostate cancer that could potentially interfere with the interpretation of this trial.
Previous treatments (RT, surgery) or comorbidities rendering new treatment with SBRT impossible.
Contra indications for intake of enzalutamide (seizure or any condition that may predispose to seizure; significant cardiovascular disease within the last three months including myocardial infarction, unstable angina, congestive heart failure, ongoing arrythmias of grade > 2 or a thromboembolic event).
Not able to understand the treatment protocol or sign informed consent.