The Impact of Metastatic Directed Radiotherapy (MDRT) on Oligoprogressive Castration Resistant Prostate Cancer (CRPC)

Launched by UNIVERSITY MEDICAL CENTER GRONINGEN · Jun 17, 2025

Keywords

ClinConnect Summary

This clinical trial is studying whether a targeted type of radiotherapy, called Metastatic Directed Radiotherapy (MDRT), can help men with a specific type of advanced prostate cancer. This cancer has stopped responding well to hormone-lowering treatments and has started to grow again, but only in a few spots (up to three). The goal is to see if treating these few growing areas with MDRT can delay the need to switch to other, often more intense, treatments like chemotherapy or new hormone drugs.

Men who might be eligible for this trial are those diagnosed with prostate cancer that no longer responds to hormone therapy, with up to three spots of cancer growth visible on special scans. They must already be on hormone therapy, and if they had chemotherapy or other treatments, these should have been completed or paused before starting this trial. Participants will receive the targeted radiotherapy to the growing cancer spots and will be carefully monitored to see how long this treatment can control the cancer before needing other treatments. This study is currently recruiting men aged 65 to 74, and those interested must agree to participate after discussing the details with their healthcare team.

Gender

MALE

Eligibility criteria

• Inclusion Criteria:
• • Adenocarcinoma of the prostate.
• • mCRPC setting, with testosterone level \< 50 ng/dl or 1.7 nmol/l.
• • Oligoprogressive disease diagnosed on PSMAscan; defined as the progression of pre-existing metastatic disease, and/or the appearance of new metastases and/or the appearance of a local relapse with a maximum of 3 lesions in total.
• • Patients currently treated with ADT, whether combined with another systemic treatment such as ARTA, chemotherapy.
• • For patients treated with chemotherapy, the course should be completed or stopped before start MORT - In case of treatment with ARTA, a minimal of 3 months response (PSA or clinical response).
• • WHO performance status 0-2.
• • Age \> = 18 years old.
• • Patiënt should be presented at the multidisciplinary tumor board of the local hospital in which the therapy will be given.
• • Before patiënt registration, written informed consent must be given according to ICH/GCO and national/local regulations.
• Exclusion Criteria:
• • Serum testosterone level \> 50 ng/ml or \> 1.7 nmol/l.
• • Presence of more than 3 progressive/new metastatic lesions and/or local recurrence (which counts for 1 lesion).
• • Active malignancy other than prostate cancer that can potentially interfere with the interpretation of the trial, except non-melanoma skin cancer or non-invasive urothelial cell carcinoma.
• • Local recurrence in the prostate after previous radiotherapy
• • Previous treatments (RT, surgery) or comorbidities making new treatment with MDRT impossible.
• • Disorder precluding understanding of trial Information or informed consent or signing informed consent.
• • Evidence of PSMA-negative disease.