Although most men with prostate cancer are diagnosed when the cancer is at the localized stage, others are not diagnosed until the cancer is advanced and has spread beyond the prostate. While five-year survival rates for prostate cancer are nearly 100 percent when it is diagnosed at the localized stage, an advanced prostate cancer diagnosis has a much lower five-year survival rate (32 percent). Additional treatment options are needed for patients with advanced prostate cancer to slow disease progression and increase survival rates.

Researchers at the University of Maryland Greenebaum Comprehensive Cancer Center (UMGCCC), led by Phuoc T. Tran, MD, Professor of Radiation Oncology, University of Maryland School of Medicine and Vice Chair for Research, UMGCCC recently launched the TERPS Trial for de Novo Oligometastatic Prostate Cancer. The goal of this new clinical trial is to test an innovative form of targeted radiation therapy to determine whether it can prevent progression of disease in patients with advanced prostate cancer.

The randomized study is focused on metastatic prostate cancer and uses stereotactic ablative radiation therapy (SABR) to target small metastases. Radiation therapy that targets metastases is a relatively recent innovation that has fewer side effects than traditional chemotherapy drugs used to treat or prevent cancer spread. The TERPS trial aims to compare the current standard of care treatment, which is composed of systemic therapy and primary prostate radiation with the standard of care treatment plus SABR targeting the metastatic lesions. The researchers are evaluating the treatment’s effect on progression and recurrence.

“This study is targeting patients who are initially diagnosed with advanced cancer that has spread. We want to see whether these patients with limited spread, called oligometastasis, experience remission and longer survival without progression this metastasis-directed radiation therapy,” Dr. Tran said.

The researchers aim to recruit 122 study participants who were initially diagnosed with prostate cancer and had oligometastases detected in their bones or soft tissue on an imaging scan. The participants will be randomly assigned to receive SABR along with standard prostate cancer therapies or to receive standard treatment alone. Standard therapies will be determined by the patient’s oncologist and can include radiation to the prostate gland, hormone therapy and chemotherapy. 

The treatment group receives treatments of SABR at the University of Maryland Medical Center as well as proton radiation therapy at the Maryland Proton Treatment Center. Patients can expect to take standard hormonal therapy to block testosterone, which feeds prostate cancers cells, for two years. Patients in the control group will have the option of crossing over into the treatment group if their disease progresses or does not go into remission following their standard treatments.

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