Darolutamide + Consolidation Radiotherapy in Advanced Prostate Cancer Detected by PSMA (DECREASE)

NCT 04319783

Brief Summary

Darolutamide is a drug that has a proven survival benefit in non-metastatic (M0) castrate resistant prostate cancer when using conventional imaging. However, it is estimated that >90% of patients have disease apparent when using PSMA PET. This study investigates the use of local consolidation radiotherapy in this cohort of men.

Intervention / Treatment 

  • Drug: Darolutamide
  • Radiation: Radiotherapy

Inclusion Criteria

  • ≥ 18 years of age and provided written Informed Consent
  • Histologically or cytologically confirmed adenocarcinoma of the prostate without neuroendocrine differentiation or small cell features
  • Castration-resistant prostate cancer, defined as at least 2 consecutive PSA rises obtained at least 1 week apart in the setting of castrate testosterone levels
  • Castrate level of serum testosterone (<1.7 nmol/l [50 ng/dl]) on gonadotrophin – releasing hormone (GnRH) agonist or antagonist therapy or after bilateral orchiectomy
  • A baseline PSA level of at least 1ng per millilitre and a PSA doubling time of 10 months or less
  • Adequate bone marrow reserve and organ function Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • At least 1 site of PSMA-avid disease on PSMA-PET/CT imaging in any of the following regions; At least 1 site of PSMA-avid disease on PSMA-PET/CT imaging in any of the following regions:
    • Local recurrence within the prostate gland or prostate bed
    • Regional lymph node disease (below the aortic bifurcation)
    • Extra-pelvic lymph node, bone or soft tissue metastatic disease

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