Metastasis-directed Therapy for Oligorecurrent Prostate Cancer

Launched by UNIVERSITAIRE ZIEKENHUIZEN KU LEUVEN · Apr 22, 2022

Keywords

ClinConnect Summary

This clinical trial is studying a new treatment approach for men with a specific type of prostate cancer called oligorecurrent hormone-sensitive prostate cancer. The researchers want to see if adding a short-term hormone therapy to a treatment that targets cancer spots (called metastasis-directed therapy) can help patients live longer without their cancer spreading. The trial is looking for men aged 18 and older who have had their primary tumor treated and currently have no more than five cancer spots outside the prostate. Participants will need to have certain levels of prostate-specific antigen (PSA) in their blood to be eligible.

If you join the trial, you will receive either one month or six months of hormone therapy along with the targeted treatment for your cancer. Throughout the study, your doctors will closely monitor your health and the effectiveness of the treatment. It's important to know that you will need to give your consent before participating, and your case will be reviewed by a team of doctors to ensure it's safe for you to join. This trial is currently recruiting participants, so it could be a good opportunity for those looking for new treatment options for their prostate cancer.

Gender

MALE

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.