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OncoMatch/Clinical Trials/NCT06625970

Study Evaluating the Efficacy and Safety of Darolutamide and Stereotactic Dose Escalated Radiotherapy in Patients With Localized Prostate Cancer and High-risk Features of Relapse

Is NCT06625970 recruiting? Yes, currently enrolling (May 2026). This Phase 3 trial studies multiple treatments including Darolutamide and ADT (Standard of Care) for high risk prostate carcinoma.

Phase 3RecruitingUNICANCERNCT06625970Data as of May 2026

Treatment: Darolutamide · ADT (Standard of Care)PEACE 7 is an international, multicenter, randomized, open-label phase III study that aims at evaluating the efficacy and safety of darolutamide and of stereotactic dose escalated prostate radiotherapy in patients with localised prostate cancer and high-risk features of relapse (defined as patients with at least 2 high-risk criteria from National Comprehensive Cancer Network (NCCN) classification) using a factorial (2x2) design. The primary objective of this study is to assess the efficacy of darolutamide and of a stereotactic dose escalated radiotherapy targeting prostate in combination with ADT and pelvic nodal radiotherapy in terms of metastasis-free survival (MSF). Patients will be randomized (1:1:1:1) to receive either: * Arm A (Standard arm): ADT + conventional fractionated or moderately hypo-fractionated prostate radiotherapy including pelvic nodal radiotherapy * Arm B (Experimental arm): ADT + conventional fractionated or moderately hypo-fractionated prostate radiotherapy including pelvic nodal radiotherapy + darolutamide * Arm C (Experimental arm): ADT + conventional fractionated or moderately hypo-fractionated pelvic nodal radiotherapy + Prostate SBRT * Arm D (Experimental arm): ADT + conventional fractionated or moderately hypo-fractionated pelvic nodal radiotherapy + Prostate SBRT + darolutamide Patient will receive systemic treatments (ADT and/or darolutamide) during 2 years where visits on site are planned at D45, D90, D180 and then every 3 months for checkups and follow prostate specific antigen (PSA) level. Metastasis-free survival (MFS) is defined as the time interval from randomization to the date of the appearance of metastasis (on next generation imaging) or death (from any cause), whichever occurs first. Radiographic evaluation will be carried out at the time of biochemical failure (Phoenix criteria) or in case of clinical suspicion. After biochemical failure (Phoenix criteria) radiographic evaluation on next generation imaging (prostate-specific membrane antigen (PSMA) positron emission tomography (PET) scan (any European Medicines Agency (EMA) approved PSMA tracer)) will be performed every 6 months until a metastatic site of relapse is identified and will be repeated at each subsequent PSA progression.

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Extracted eligibility criteria

Cancer type

Prostate Cancer

Disease stage

Excluded: Stage IV, PELVIC LYMPH NODE METASTASIS

Clinically or radiologically detectable metastasis, including no evidence of pelvic lymph node metastasis on next generation imaging (PSMA PET/CT), nor enlarged pelvic lymph nodes (≥1 cm in small diameter) on MRI

Performance status

ECOG 0–1(Restricted strenuous activity)

Prior therapy

No prior treatment (treatment-naive required)
Max 0 prior lines

Cannot have received: prostatectomy

Exception: lymph node dissection (patients with PN- disease only can be accrued)

Prior treatment for prostate cancer, including prostatectomy, except lymph node dissection (patients with PN- disease only can be accrued)

Cannot have received: androgen deprivation therapy

Exception: ADT started more than 6 weeks before randomization

Prior treatment for prostate cancer, including ... ADT (started more than 6 weeks before randomization)

Cannot have received: second generation androgen receptor inhibitor

Prior treatment with second generation androgen receptor (AR) inhibitors, other investigational AR inhibitors, or CYP17 enzyme inhibitor

Cannot have received: CYP17 enzyme inhibitor

Prior treatment with ... CYP17 enzyme inhibitor

Cannot have received: oestrogen

Use of oestrogens or 5-α reductase inhibitors or AR inhibitors

Cannot have received: 5-α reductase inhibitor

Use of oestrogens or 5-α reductase inhibitors or AR inhibitors

Cannot have received: androgen receptor inhibitor

Use of oestrogens or 5-α reductase inhibitors or AR inhibitors

Cannot have received: chemotherapy

Prior chemotherapy or immunotherapy for prostate cancer

Cannot have received: immunotherapy

Prior chemotherapy or immunotherapy for prostate cancer

Cannot have received: radiotherapy

Previous treatment for prostate cancer (surgery or radiotherapy) or previous pelvic irradiation that would make prostate/pelvis radiotherapy impossible

Cannot have received: pelvic irradiation

previous pelvic irradiation that would make prostate/pelvis radiotherapy impossible

Lab requirements

Blood counts

Absolute neutrophil count ≥ 1.5 x 10⁹/L; Platelet count ≥100 x 10⁹/L; Haemoglobin ≥90 g/L (in absence of red blood cell transfusion within 4 weeks prior to randomization)

Kidney function

Creatinine ≤2.0 x ULN

Liver function

ALT and/or AST ≤2.5 x ULN, total bilirubin ≤1.5 x ULN

Absolute neutrophil count ≥ 1.5 x 10⁹/L; Platelet count ≥100 x 10⁹/L; Haemoglobin ≥90 g/L (in absence of red blood cell transfusion within 4 weeks prior to randomization); Hepatic function: serum alanine aminotransferase (ALT) and/or aspartate transaminase (AST) ≤2.5 x upper limit of normal (ULN), total bilirubin ≤1.5 x ULN; Creatinine ≤2.0 x ULN

Structured fields extracted by AI. May contain errors — verify against the official protocol.

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