MDRT in Prostate Cancer Treated With Long-term Androgen Deprivation Therapy in the STAMPEDE Trial (METANOVA)

Standard androgen deprivation therapy (ADT) will be administered at the discretion of treating physician.

Standard androgen receptor signaling inhibitors (ARSI) will be administered at the discretion of the treating physician.

"Local therapy will either be radiotherapy (RT) or radical prostatectomy (RP).~* Prostate +/- pelvic nodal radiation~* Radical prostatectomy + pelvic lymph node dissection"

In participants randomized to the MDRT arm, MDRT to all lesions will be performed by the end of Week 24. Selection of a particular regimen (the dose and fractionation) will based on the size and location of the participant's metastatic site and the surrounding normal tissue constraints.