Metastasis-directed therapy in castration-refractory prostate cancer: MEDCARE

MEDCARE aims at evaluating the role of metastasis-directed therapy (MDT) in oligoprogressive/oligorecurrent metastatic castration-resistant prostate cancer (mCRPC). Step 1 includes a retrospective analysis of a pool of patients treated at the University Hospitals Leuven. This analysis demonstrates a next systemic therapy free survival (NEST-FS) of 16 months after MDT in oligoprogressive/oligorecurrent MCRPC. These data are unique and may induce a paradigm shift in the treatment of these patients. Based on these results, we will first initiate a non-randomized prospective trial to confirm the data obtained from the retrospective analysis. Translational research includes technical planning comparison between best of photon plan compared with a proton plan. Endpoints include coverage of the metastatic lesion and dose to the surrounding organs at risk. PSMA PET-CT will be performed to study its predictive value on NEST-FS. The ultimate goal is the initiation of a phase 3 randomized controlled trial with overall survival as endpoint.