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Androgen-responsive POSLUMA-guided Intra-prostatic Boost

Androgen-responsive POSLUMA-guided Intra-prostatic Boost (ARPEGGIO)

Who can join

Ages 18 and older · Men

Inclusion Criteria:

* 18 years of age and older.
* Eastern Oncology Group Status 0 to 1.
* Histologic diagnosis of prostate cancer.
* Prior screening MRI with at least one PI-RADS4 or PI-RADS 5 lesion, obtained within 180 days of screening.
* NCCN intermediate-risk or high-risk prostate cancer (Appendix B). All patients will be staged by MRI.
* Prior PSMA PET scan with at least one focal avid lesion greater than background prostate that is concordant with a lesion on MRI, obtained within 180 days of screening.
* Intention for SBRT (36.25 Gy/5 fraction) with focal boost (up to 50 Gy) to one MRI/PET-concordant lesion34.

Exclusion Criteria:

* Prior imaging (CT, bone scan, MRI, PSMA-PET/CT) showing nodal or distant disease.
* Intention to receive treatment intensification with secondary androgen receptor signaling inhibitors or chemotherapy.
* Clinical T4 disease.
* Prior ADT.
* Prior pelvic RT.
* Prior prostate surgery, including TURP.
* International prostate symptom score \> 20.
* Prior urethral stricture.
* Prostate volume \> 80 cc on MRI.
* Hip implants that cause artifacts over the prostate gland.
* Inability to discontinue anti-coagulation for fiducial marker placement.
* Active Crohn's disease or scleroderma.

About the study

This research study is for men with intermediate- or high-risk prostate cancer who are planning to receive hormone therapy and radiation treatment. The purpose of the study is to see whether a special type of diagnostic imaging done during hormone therapy can help doctors more accurately target remaining cancer with radiation, while avoiding areas that may no longer need extra treatment. All participants will receive standard hormone therapy and radiation therapy, along with three imaging scans, over a six-month period. The information gained from this study may help make prostate cancer radiation treatment more precise and reduce side effects for future patients.

What is being tested

• PSMA PET/CT (diagnostic test)
• Androgen Deprivation Therapy (ADT) +/- bicalutamide (drug)
• Stereotactic Body Radiation Therapy (SBRT) +/- focal microboost (radiation)

Sponsor: Martin T. King, MD, PhD · Participants: 23 · Started: Apr 29, 2026

Contact the study team

Official record on ClinicalTrials.gov — NCT07393867

Locations in the U.S.

Conditions

• Prostate Cancer

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.