Duration of Androgen Receptor Pathway Inhibitor and ADT With Metastasis Directed Therapy in Oligometastatic Cancer of the Prostate (DIRECT)

To join this study, you need to be a man over 18 years old who has been diagnosed with prostate cancer that has spread to nearby areas (Stage IV) within the last six months. Importantly, your cancer should only have spread to a few spots (between 1 and 10). Some of these spots might only show up on a special type of scan called a PSMA PET scan, with only one spot visible on more common scans like CT or bone scans. All the areas where the cancer has spread must be treatable with radiation therapy.

It's also essential that you are generally well enough to take part, meaning you can carry out most of your daily activities without much difficulty. You must also be able to understand the study and agree to participate. A key point is that you should prefer not to have continuous hormone therapy as an ongoing treatment.

If you decide to take part in this study, you will be assigned to one of two groups by chance – like flipping a coin. One group will receive the standard treatment, which includes radiation therapy and hormone therapy (ADT). The other group will receive the standard radiation and hormone therapy, plus an extra tablet called enzalutamide for about 8 to 9 months.

Over the next five years, you'll have regular check-ups, either by visiting the clinic or through remote appointments (like phone calls or video calls). These check-ups are to see how you're responding to the treatment, monitor your health, and understand how the treatment affects your quality of life. This ongoing monitoring will help the study team learn whether the additional treatment makes a difference.