TERPS Trial for De Novo Oligometastic Prostate Cancer

Clinicaltrials.gov ID: NCT05223803
db-list-check Status RECRUITING
b-loader Phase PHASE2
b-people Age ≥ 18 Years
b-bullseye-arrow Enrollments 122

Conditions

Prostate Cancer, Oligometastatic Disease

Drugs

Systemic Therapy

Summary

This research is being done to see if we can improve the outcome of prostate cancer patients who present with metastatic lesions at initial diagnosis.

Detailed Description

This study will compare the effects, good and/or bad, of using the standard of care treatment (systemic therapy + primary prostate radiation) compared to standard of care treatment plus stereotactic ablative radiation therapy (SABR) to metastatic lesions for prostate patients. The researchers are also trying to learn if the addition of SABR will affect recurrence rates. Presence of circulating tumor cells, gut bacteria, and quality of life will be assessed for both groups.

Locations

8 locations Found with status Recruiting

Status

  • RECRUITING

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  • RECRUITING

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  • RECRUITING

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  • RECRUITING

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  • RECRUITING

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  • RECRUITING

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  • RECRUITING

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  • RECRUITING

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Eligibility Criteria

Inclusion Criteria:

1. Patient must have at least one and up to three asymptomatic metastatic tumor(s) of the bone or soft tissue (with at least one bone metastasis) develop within the past 6-months that are seen on imaging. Up to five lesions are allowed on advanced functional imaging such as fluciclovine (Axumin), choline or PSMA PET-CT scan.

1. CT or MRI scan within 6 months of enrollment
2. Bone scan within 6 months of enrollment
3. Fluciclovine (Axumin), choline, or PSMA PET-CT scan within 6 months of enrollment (PET-CT scan is reasonable for study entry imaging as an alternative to CT/MRI scan and bone scan)
2. Histologic confirmation of malignancy (primary or metastatic tumor).
3. Patient may have had prior systemic therapy and/or ADT associated with treatment within 9-months of enrollment.
4. PSA > 0.5 but <100.
5. Patient must be ≥ 18 years of age.
6. Patient must have a life expectancy ≥ 12 months.
7. Patient must have an ECOG performance status ≤ 2.
8. Patient must have the ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

1. Castration-resistant prostate cancer (CRPC).
2. Prior radiation therapy to an overlapping site of a target lesion that would preclude further radiation therapy
3. Spinal cord compression or impending spinal cord compression.
4. Suspected pulmonary and/or liver metastases (greater >10 mm in largest axis).
5. Patient receiving any other investigational agents.
6. Inability to receive any form of systemic therapy in the opinion of a treating medical oncologist .
7. Unable to lie flat during or tolerate PET/MRI, PET/CT or SABR.
8. No radiographical evidence of cranial metastasis.
9. Refusal to sign informed consent.

Study Plan

Best systemic therapy (BST) + primary prostate radiation (XRT)

  • RADIATION:

    Prostate radiation (XRT)

    Description:

    Both arms will receive prostate radiation. Multiple treatment regimens are allowed per protocol.
  • DRUG:

    Systemic Therapy

    Description:

    All systemic therapy is provided as best prescribed for patient per their medical oncologist.

BST + XRT + SABR metastasis-directed therapy (MDT)

  • RADIATION:

    Prostate radiation (XRT)

    Description:

    Both arms will receive prostate radiation. Multiple treatment regimens are allowed per protocol.
  • DRUG:

    Systemic Therapy

    Description:

    All systemic therapy is provided as best prescribed for patient per their medical oncologist.
  • RADIATION:

    Stereotactic ablative radiation therapy (SABR)

    Description:

    SABR is delivered to those randomized to Arm 2.

Outcome Measures

Primary Outcome Measures

To determine the 2-year failure-free survival (FFS) of men who have oligometastatic prostate cancer with BST+XRT versus BST+XRT+SABR MDT.

Time Frame: 2 years

Secondary Outcome Measures

To determine the number of participants with toxicities related to SABR MDT in patients with de novo oligometastatic disease

Time Frame: 5 years

To determine local control at 12-months after SABR MDT in patients with de novo oligometastatic disease.

Time Frame: 1 year

To assess time to progression

Time Frame: 5 years

Quality of life assessed through EPIC tool utilizing patient scores in each function group following completion of SABR MDT.

Time Frame: 5 years

Timeline

  • Last Updated
    September 25, 2024
  • Start Date
    February 4, 2022
  • Today
    February 5, 2025
  • Completion Date ( Estimated )
    July 31, 2027

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