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Prostate CancerPhase 2NCT06111313

The University of Miami Adapt (UAdapt) Trial

A Phase 2 study testing FTLEAD, Ultra-Short-Term Androgen Deprivation Therapy with Relugolix and HypoLEAD in people with Prostate Cancer, run by University of Miami at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The purpose of this prostate cancer research study is to investigate: 1. For early-stage patients, the use of a single session of high dose stereotactic body radiotherapy (SBRT) delivered to the tumor within the prostate, not to the entire prostate, as curative treatment of prostate cancer; 2. Read more about this study

Who is it for?
Ages 35 to 85 years, men only
Conditions the study is for
Prostate Cancer
What is being tested?
FTLEAD, Ultra-Short-Term Androgen Deprivation Therapy with Relugolix and HypoLEAD
Could I receive a placebo?
No, everyone receives an active treatment
How many people
130 participants
Where
1 siteUnited States
Study dates
6 Nov 2024to 30 Nov 2033
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 35 to 85 years
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Biopsy confirmed adenocarcinoma of the prostate (including intraductal adenocarcinoma, excluding small cell carcinoma).
  • T1-T3 disease based on digital rectal exam (DRE), informed by mpMRI. Prostate MRI may aid in the staging evaluation by verifying organ-confined status6,7. The ability to distinguish between organ-confined tumors (≤T2c) and those that extend beyond the prostate (≥T3a) is an important component of treatment decision making.
  • Patients with T3 disease based on DRE, mpMRI, Gleason 8-10, or a PSA of >15 ng/mL, should undergo a negative metastatic workup prior to signing of consent. A questionable bone scan is acceptable if additional imaging studies; eg, plain x-rays, CT, MRI, prostate specific membrane antigen (PSMA) positron emission tomography (PET)/CT do not confirm for metastasis.
  • No evidence of metastasis by clinical criteria or available radiographic tests (N0M0 by clinical or imaging criteria).
  • Gleason score 6-10.
  • Prostate specific antigen (PSA) ≤100 ng/mL within (≤) 3 months of signing of consent. If PSA was above 100 ng/mL and drops to ≤100 ng/mL with antibiotics, this is acceptable for enrollment.
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  • Suspicious peripheral zone or central gland lesion(s) on mpMRI.
  • Peripheral zone: Distinct lesion on dynamic contrast enhanced (DCE)-MRI with early enhancement and later washout (Note: contrast not required for enrollment), and/or distinct lesion on the apparent diffusion coefficient (ADC) map (Value <1000).
  • Central gland: A suspicious central gland lesion on mpMRI must have a distinct lesion on the ADC map (Value <1000).
  • No previous pelvic radiotherapy.
  • No previous history of radical/total prostatectomy (suprapubic prostatectomy is acceptable).
  • No concurrent, active malignancy, other than nonmetastatic skin cancer or early-stage chronic lymphocytic leukemia (well-differentiated small cell lymphocytic lymphoma). If a prior malignancy is in remission for ≥5 years, then the patient is eligible.
  • Ability to understand and the willingness to sign a written informed consent document.
  • Zubrod performance status ≤2. Karnofsky or Eastern Cooperative Oncology Group (ECOG) performance status may be used to estimate Zubrod.
  • Age ≥35 and ≤85 years at signing of consent.
  • Serum testosterone is within 40% of normal assay limits (eg, x=0.4*lower assay limit and x=0.4*upper assay limit + upper assay limit), taken within (≤) 3 months of signing of consent.
  • For patients in HypoLEAD cohort, post-LEAD RT androgen deprivation therapy, including use of secondary agents (eg, abiraterone), is at the discretion of the treating physician but must be declared as none, short-term or long-term prior to enrollment. Note that this ADT regimen differs from the uSTADT regimen. If antiandrogen therapy (eg, bicalutamide) or ADT (LHRH agonist or antagonist injection) is planned, the following restrictions apply:
  • Anti-androgen therapy and ADT must be started after 3-week post-LEAD RT gradient biopsy.
  • Anti-androgen therapy and ADT are recommended to be started prior to or concurrent with start of moderately hypofractionated RT course and must be started before the end of the hypofractionated RT course.
  • The total length planned must be ≤ 30 months.
  • Patient unable to receive iodine or gadolinium contrast due to allergy or poor renal function are still eligible for enrollment.

Who cannot join

  • Prior pelvic radiotherapy.
  • Prior androgen ablation therapy.
  • Prior or planned radical prostate surgery.
  • Clinical, radiographic, or pathologic evidence of nodal or distant metastatic disease with the following specifications: PSMA-PET or Fluciclovine PET: Patients with subclinical (<1.5 cm) pelvic lymph nodes that are suspicious on such PET scans will be ineligible for FTLEAD, however will still be eligible for HypoLEAD. In the latter case the treating physician may boost such nodes to a higher dose.
  • Concurrent, active malignancy, other than nonmetastatic skin cancer or early-stage chronic lymphocytic leukemia (well-differentiated small cell lymphocytic lymphoma). If a prior malignancy is in remission for > 5 years, then the patient is eligible.
  • Zubrod status >2.
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  • Pretreatment PSA >100 ng/ml or Gleason score <6. If PSA was above 100 ng/mL and drops to ≤100 ng/mL with antibiotics, this is acceptable for enrollment.
  • Thyroxine (T4) disease.
  • Patients with impaired decision-making capacity who lack the ability to understand and voluntarily sign a written informed consent document.
  • Patients unable to tolerate diagnostic MRI acquisition. Note: inability to tolerate contrast agents is not exclusionary.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Benjamin Spieler, MD contact

305-243-4229

bxs737@med.miami.edu

United States1 site, 1 recruiting
  • University of Miami

    Miami, Florida, 33136

    Benjamin Spieler, MD, 305-243-4229, bxs737@med.miami.edu

    Benjamin Spieler, MD

    Recruiting

Other trials in United States

About this study

Official title: A Phase 2 Risk Adapted Parallel Randomized Trial of MRI-Guided Lattice Stereotactic Focal Radiotherapy of the Prostate With or Without Ultra-Short Term Androgen Deprivation Therapy-The Miami UAdapt Trial

The purpose of this prostate cancer research study is to investigate:

  1. For early-stage patients, the use of a single session of high dose stereotactic body radiotherapy (SBRT) delivered to the tumor within the prostate, not to the entire prostate, as curative treatment of prostate cancer;
  2. The addition of ultra short-term androgen supression (uSTAS) to a single session of high dose SBRT as a means of intensifying treatment while preserving quality of life and minimizing side effects;
  3. The ability of a single session of high dose SBRT to activate your immune system to enhance eradication of prostate cancer;
  4. For higher risk patients, the use of a single session of high dose SBRT to the tumor only followed by 25 sessions of radiotherapy targeting the whole prostate as a means to improve control of disease while preserving quality of life and minimizing side effects;
  5. The relationship between diagnostic imaging studies and prostate biopsy results in assessing clinical outcomes; and
  6. The relationship of pre- and post-treatment prostate biopsy results and imaging studies, such as MRI and PET/CT.
Conditions
Prostate Cancer
Being tested
FTLEAD, Ultra-Short-Term Androgen Deprivation Therapy with Relugolix, HypoLEAD, ADT Standard of Care
Medical subject headings
Prostatic Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • FTLEADRadiation

    In focal therapy lattice extreme ablative (FTLEAD) RT, the multiparametric-MRI (mpMRI) defined gross tumor volume (GTV) will receive 16-20 Gy in a single fraction of RT to the targeted area which is the tumor within the prostate, with or without uSTADT.

  • Ultra-Short-Term Androgen Deprivation Therapy with RelugolixDrug

    Ultra-Short-Term Androgen Deprivation Therapy (uSTADT) is hormone therapy that includes Relugolix. Patients will receive a loading dose of uSTADT for a total duration 4 weeks (28 days), with oral LHRH antagonist relugolix administered daily starting 2 weeks prior to LEAD RT and continuing until 2 weeks afterwards as per Study Calendar. Patients randomized to uSTADT will receive a loading dose of 360 mg of oral relugolix on Day 14 followed by 120 mg of oral relugolix daily from Day 13 to Day 14. Patients will be instructed to take relugolix orally once daily at approximately the same time each day. Patients may take relugolix with or without food and should swallow tablets whole and not crush or chew tablets.

  • HypoLEADRadiation

    In Hypofractionated LEAD (HypoLEAD), the multiparametric-MRI (mpMRI) defined GTV will receive 12-16 Gy in a single fraction on the first day of treatment, with or without uSTADT. Four weeks after LEAD RT, patients will begin whole prostate moderately hypoLEAD (67.5 Gy in 25 fractions) with pelvic nodal irradiation and further ADT at the discretion of the treating physician.

  • ADT Standard of CareDrug

    Participants will receive ADT as per standard of care (SOC).

Study groups in NCT06111313
Study groupRoleWhat they receive
Focal Therapy lattice extreme ablative dose (FTLEAD), RT Only, Arm AExperimentalParticipants in this group will receive the FTLEAD treatment only and will be followed for up to 5.5 years.
Receives: Radiation: FTLEAD
Focal Therapy lattice extreme ablative dose (FTLEAD), uSTADT, Arm BExperimentalParticipants in this group will receive the FTLEAD treatment and ultra short-term androgen deprivation therapy (ADT) and will be followed for up to 5.5 years.
Receives: Radiation: FTLEAD; Drug: Ultra-Short-Term Androgen Deprivation Therapy with Relugolix
Lattice extreme ablative dose followed by hypofractionated RT (HypoLEAD), Arm CExperimentalParticipants in this group will receive LEAD RT followed by moderately hypofractionated RT (HypoLEAD) and standard of care androgen deprivation therapy and will be followed for 5.5-8 years.
Receives: Radiation: FTLEAD; Radiation: HypoLEAD; Drug: ADT Standard of Care
Lattice extreme ablative dose followed by hypofractionated RT (HypoLEAD), uSTADT, Arm DExperimentalParticipants in this group will receive LEAD RT with ultra short-term ADT followed by moderately hypofractionated RT (HypoLEAD) and standard of care ADT and will be followed for 5.5-8 years.
Receives: Radiation: FTLEAD; Drug: Ultra-Short-Term Androgen Deprivation Therapy with Relugolix; Radiation: HypoLEAD; Drug: ADT Standard of Care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of Patients with Biochemical Disease Failure (FFBN9mo)

    Biochemical Disease Failure will be determined by the proportion of patients with biochemical disease failure.

    Measured: Up to 14 Months

  2. Proportion of Patients with Clinical Disease Failure

    Clinical Disease Failure will be determined by the proportion of patients with clinical disease failure. Clinical disease failure will include the proportion of patients with biopsy finding of treatment failure.

    Measured: Up to 14 Months

Secondary outcomes (4)
  1. Proportion of Patients with Biochemical Disease Failure (Phoenix definition)

    Biochemical Disease Failure will be determined by the proportion of patients with biochemical disease failure.

    Measured: Up to 2.5 years

  2. Proportion of Patients with Clinical Disease Failure

    Clinical Disease Failure will be determined by the proportion of patients with clinical disease failure. Clinical disease failure will include the proportion of patients with biopsy finding of treatment failure.

    Measured: Up to 2.5 years

  3. Number of Treatment Related Acute toxicity

    Acute toxicity is defined as grade 2+ and grade 3+ treatment-related acute genitourinary (GU)/gastrointestinal (GI) toxicity occurring during treatment and within 3 months of completing treatment. The severity of the reactions to treatment will be scored according to the criteria outline in CTCAE version 5.0.

    Measured: Up to 3 months

  4. Number of Treatment Related Late toxicity

    Late toxicity is defined as grade 2+ and grade 3+ treatment-related GU/GI toxicity occurring more than 3 months after completing study treatment. The severity of the reactions to treatment will be scored according to the criteria outline in CTCAE version 5.0.

    Measured: Up to 8 Years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Nov 2023
  2. Study start6 Nov 2024
  3. Primary completion30 Nov 2028 (estimated)
  4. Study completion30 Nov 2033 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
The Miami UAdapt Trial is a non-comparative phase II study that includes two parallel randomized cohorts that will prospectively assign men radiotherapy (RT) treatment. Patients with relatively favorable risk prostate cancer (PCa) will be eligible for focal therapy LEAD (FTLEAD) RT (n=40), and randomized to receive Lattice Extreme Ablative Dose (LEAD) single high dose RT (SDRT, 12-16 Gy) vs. the same overall plan with the addition of ultrashort-term ADT (uSTADT, 1 month duration) concurrent with SDRT. Higher risk patients are assigned to the HypoLEAD cohort (n=40) and randomized 1:1 to receive Lattice Extreme Ablative Dose (LEAD) single high dose RT (SDRT, 16-20 Gy) followed by moderately hypofractionated (HypoFx) RT for 25 additional fractions vs. the same overall plan with the addition of ultrashort-term ADT (uSTADT, 1 month duration) concurrent with SDRT. In HypoLEAD additional ADT will be assigned at physician discretion per standard of care.
Masking
None (open label)
Enrolment
130 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06111313
Sponsor's protocol ID
20230097
Status last verified
Feb 2026
First submitted
26 Oct 2023
Last updated
18 Feb 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing FTLEAD, Ultra-Short-Term Androgen Deprivation Therapy with Relugolix and HypoLEAD in people with Prostate Cancer, run by University of Miami at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 21 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 18 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Benjamin Spieler, MD (305-243-4229, bxs737@med.miami.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of Patients with Biochemical Disease Failure (FFBN9mo) (time frame: Up to 14 Months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Feb 2026.

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