Tests combined drug and focused ultrasound treatment for advanced prostate cancer

Trial details

Who runs it

Qilu Hospital of Shandong University

Trial code

NCT07172685

Record updated

15 September 2025

Original description

This study is a single-arm prospective cohort study designed to evaluate the efficacy and safety of triple therapy (ADT + darolutamide + docetaxel) combined with transrectal high-intensity focused ultrasound (HIFU) focal therapy in patients with high-tumor-burden metastatic hormone-sensitive prostate cancer (mHSPC).Read full original descriptionShow less

Exploratory Study on the Efficacy and Safety of Triple Therapy (ADT + Darolutamide + Docetaxel Chemotherapy) Combined With Transrectal High-Intensity Focused Ultrasound Focal Therapy in Metastatic Hormone-Sensitive Prostate Cancer (mHSPC) With High Tumor Burden

This study is a single-arm prospective cohort study designed to evaluate the efficacy and safety of triple therapy (ADT + darolutamide + docetaxel) combined with transrectal high-intensity focused ultrasound (HIFU) focal therapy in patients with high-tumor-burden metastatic hormone-sensitive prostate cancer (mHSPC).

A total of 116 high-tumor-burden mHSPC patients will be enrolled and are scheduled to receive the following treatment:

Darolutamide + Docetaxel + ADT + Transrectal HIFU Focal Therapy for the Prostate.

Inclusion: Patients who agree to participate in the study and sign the informed consent form; Age ≥18 years, male; Histologically or cytologically confirmed prostate adenocarcinoma; Bone scan, CT, or MRI showing ≥4 bone metastases (with ≥1 outside the pelvis or spine) or visceral metastases; Newly diagnosed or recurrent disease after local therapy, with sensitivity to androgen deprivation therapy (ADT); Patients who have received ADT (medical or surgical castration) with or without first-generation antiandrogens for ≤3 months, without evidence of soft tissue disease progression (per RECIST 1.1) or clinically significant PSA progression (≥50% increase from nadir with serum testosterone at castrate levels); Planned treatment with docetaxel plus apalutamide and ADT, or apalutamide plus ADT; ECOG Performance Status (PS) score of 0-1; Adequate hematologic and organ function:; **Bone marrow function (without transfusion or growth factor support):**; Absolute neutrophil count (ANC) ≥1.5 × 10⁹/L (1500/μL); Hemoglobin ≥90 g/L (9.0 g/dL); Platelet count ≥100 × 10⁹/L (100,000/μL); **Liver function:**; Total bilirubin (TBIL) ≤1.5 × ULN; AST, ALT, and alkaline phosphatase (ALP) ≤2.5 × ULN; **Renal function:**; Serum creatinine ≤1.5 × ULN **or** calculated creatinine clearance ≥30 mL/min (Cockcroft-Gault formula); **Coagulation function (without anticoagulation therapy):** INR ≤1.5; Patients of reproductive potential must use effective contraception during the study and for 6 months after the last dose.

Exclusion: Lesions located at the prostate apex or in areas inaccessible for focal therapy; Urethral stricture or presence of metal/other implants in the urethra; Prior rectal surgery; Planned concurrent anticancer therapy during the study; Prior treatment with second-generation androgen receptor (AR) inhibitors (e.g., apalutamide, enzalutamide, darolutamide), CYP17 inhibitors (e.g., abiraterone acetate, ketoconazole), chemotherapy, immunotherapy, or adjuvant/neoadjuvant therapy; Use of herbal products with anti-prostate cancer or PSA-lowering effects (e.g., saw palmetto) within 4 weeks before study treatment; Active cardiac disease within 6 months before treatment: severe/unstable angina, myocardial infarction, congestive heart failure (NYHA Class III/IV), or arrhythmia requiring medication; Concurrent participation in another investigational drug/device trial; History of or existing rectal fistula; Active severe urinary tract infection; Severe cardiovascular or cerebrovascular disease affecting anesthesia/surgery; History of hypersensitivity or intolerance to any study drugs; History of seizures, medications that lower seizure threshold, or conditions predisposing to seizures within 12 months (including TIA, stroke, or traumatic brain injury with hospitalization); Conditions impairing drug absorption (e.g., dysphagia, chronic diarrhea, intestinal obstruction); Immunodeficiency (e.g., HIV-positive, congenital/acquired immunodeficiency) or organ transplant history; Other malignancies within 5 years (except cured basal cell carcinoma or cervical carcinoma in situ); Uncontrolled comorbidities (e.g., hypertension, diabetes, neuropsychiatric disorders) that may compromise safety or confound results, per investigator judgment; Any other condition deemed unsuitable for inclusion by the investigator; Beaded prostatic calculi or cysts >1 cm in diameter within the treatment or ultrasound pathway; Rectal stenosis preventing transrectal ultrasound; Rectal invasion; Known brain metastases; Poor compliance likely to hinder treatment/follow-up.

ClinicalTrials.gov NCT07172685