A Randomised Controlled Platform Trial Testing Treatments in Metastatic Hormone Sensitive Prostate Cancer

This study is particularly for men who are at least 18 years old and have prostate cancer that has spread to other parts of their body, such as bones or other organs. The cancer must still be responding to hormone treatment, or if you've had previous hormone treatment, it needs to have stopped at least two years ago and you haven't had too much hormone treatment in total.

To join, doctors need to confirm your prostate cancer diagnosis, usually through a biopsy (tissue sample) or strong clinical suspicion. Scans like CT, MRI, or PET will have shown where the cancer has spread. Your overall health and ability to go about your daily activities should be generally good (what doctors call a WHO Performance Status of 0-2), or if you're a bit less active (Status 3), it should be mainly due to the cancer spread and expected to improve once you start hormone treatment.

It's also important that you have either started long-term hormone therapy or are planning to start it for at least two years. The research team will review all your medical information to make sure this study is the right fit for you.

If you decide to take part in STAMPEDE2, you'll first be registered for the study. Then, a computer system will randomly decide whether you receive the standard care or the standard care plus one of the new research treatments (SABR or PSMA-Lutetium). There's a 50% chance of getting one of the research treatments. Neither you nor your doctor can choose which treatment you receive; this helps ensure the study results are fair and unbiased.

Throughout the study, you'll have regular hospital visits for scans, blood tests, and other checks to monitor your cancer and how you're responding to treatment. The doctors will also carefully check for any side effects from the medicines. The specific number of visits and tests will depend on which comparison group you are in and will be explained in detail by the study team. Treatment will stop if the side effects become too severe, or if you simply decide you no longer wish to continue with the study.

The total duration of your participation in the treatment part of the study will vary, but even after treatment, you will be followed up with scans and tests. Your commitment to these follow-up appointments is important to gather complete information about the long-term effects of the treatments. You are free to withdraw from the trial at any time, for any reason.