Intermittent Androgen Deprivation Therapy With or Without Stereotactic Body Radiotherapy for Molecularly Identified Hormone Sensitive Oligometastatic Prostate Cancer

Inclusion Criteria

• •1. Age \> 18 years.
• •2. Able to provide informed consent.
• •3. Histologic diagnosis of prostate adenocarcinoma.
• •4. ECOG performance status 0-1.
• •5. Stage IV hormone sensitive, synchronous or metachronous oligometastatic prostate cancer as detected by PSMA PET-CT scan with no metastases visible on conventional imaging (CT chest/abdomen/pelvis and bone scan +/- MRI) performed within 3 months of starting ADT.
• •6. Up to a maximum of 3 PSMA avid areas of metastatic disease.
• •7. For patients with metachronous disease, there must be a documented PSA rise. For those who had previous prostatectomy, PSA must be \> 0.2 ng/mL. For those who had previous radical radiotherapy, PSA must have risen to at least 2 ng/mL above the nadir (Phoenix definition). The primary tumor must be controlled, with no PSMA avid progression within the primary prostate.
• •8. All sites of disease are amenable to and can be safely treated with SBRT.