Study: NCT04787744

Intervention type: OTHER
Group type: EXPERIMENTAL
Intervention: Salvage Local Therapy for locally recurrent disease
Description: For Veterans who have a local recurrence in addition to oligorecurrent metastatic lesions, they will undergo salvage local therapy using brachytherapy, SBRT, surgery, cryotherapy or HIFU. The selection of modality of salvage local therapy will be determined using shared decision-making between the treating physician and Veteran.

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: Goserelin, Histrelin, Leuprolide & Triptorelin
Description: Androgen deprivation therapy (ADT) using an LHRH agonist

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: Goserelin, Histrelin, Leuprolide & Triptorelin
Description: Androgen deprivation therapy (ADT) using an LHRH agonist

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: ADT + Nilutamide, Flutamide, & Bicalutamide
Description: ADT adding anti-androgen therapy to an LHRH agonist

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: ADT + Nilutamide, Flutamide, & Bicalutamide
Description: ADT adding anti-androgen therapy to an LHRH agonist

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: Degarelix & Relugolix
Description: ADT using an LHRH Antagonist.

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: Degarelix & Relugolix
Description: ADT using an LHRH Antagonist.

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: ADT + Docetaxel +/- prednisone
Description: Enhanced SST using chemohormonal therapy

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: ADT + Docetaxel +/- prednisone
Description: Enhanced SST using chemohormonal therapy

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: ADT + Abiraterone + Prednisone
Description: Enhanced SST using Abiraterone + Prednisone

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: ADT + Abiraterone + Prednisone
Description: Enhanced SST using Abiraterone + Prednisone

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: ADT + Abiraterone + Methylprednisolone
Description: Enhanced SST using Abiraterone + Methylprednisolone

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: ADT + Abiraterone + Methylprednisolone
Description: Enhanced SST using Abiraterone + Methylprednisolone

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: ADT + Apalutamide
Description: Enhanced SST using ADT + Apalutamide

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: ADT + Apalutamide
Description: Enhanced SST using ADT + Apalutamide

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: ADT + Enzalutamide
Description: Enhanced SST using ADT + Enzalutamide

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: ADT + Enzalutamide
Description: Enhanced SST using ADT + Enzalutamide

Intervention type: RADIATION
Group type: EXPERIMENTAL
Intervention: Prostate-directed Radiation for De novo oligometastatic prostate cancer
Description: Veterans in ARM 1 will receive prostate-directed RT only and NO treatment to any nodal or distant metastatic sites.~Acceptable dose/fractionations include 55 Gy in 20 fractions and 36 Gy in 6 fractions.~Veterans in ARM 2 should receive prostate-directed local therapy using radiotherapy or radical prostatectomy in addition to PET-directed local therapy to metastases.

Intervention type: RADIATION
Group type: ACTIVE_COMPARATOR
Intervention: Prostate-directed Radiation for De novo oligometastatic prostate cancer
Description: Veterans in ARM 1 will receive prostate-directed RT only and NO treatment to any nodal or distant metastatic sites.~Acceptable dose/fractionations include 55 Gy in 20 fractions and 36 Gy in 6 fractions.~Veterans in ARM 2 should receive prostate-directed local therapy using radiotherapy or radical prostatectomy in addition to PET-directed local therapy to metastases.