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Phase II Trial of PSA Response-based Androgen Deprivation Therapy and Nodal Coverage for Prostate Cancer Early Salvage Radiotherapy (RANGER)

  • PhasePhase 2
  • StatusRecruiting
  • Planned enrollment68 people
  • Recruiting US sites1
  • SponsorUniversity of Texas Southwestern Medical Center
  • RegistryNCT07313241

Recruitment re-checked on ClinicalTrials.gov Oct 30, 2026. Public record; not medical advice.

Phase II Trial of PSA Response-based Androgen Deprivation Therapy and Nodal Coverage for Prostate Cancer Early Salvage Radiotherapy (RANGER): a one-minute explainerNCT073132411 min

Eligibility

Who can join

The film gives the main points. The full list below is copied from the registry; the study team makes the final decision.

  • Age18 Years to no maximum
  • SexMale
  • Healthy volunteersNo

You may be able to join if

  • Men aged ≥18 years with histologically confirmed prostate adenocarcinoma treated with prostatectomy in the localized setting within 10 years, with post-operative PSA (persistent or rising) of ≥0.05ng/mL.
  • Radical prostatectomy ≥4 months prior to enrollment without nodal involvement (pN0 or pNx)
  • Performance status ECOG 0-2
  • No definite evidence of regional or distant metastatic disease by at least pelvic imaging within 90 days of registration. Equivocal findings are allowed at investigator discretion. Imaging is specified as follows:
  • PSA>=0.2ng/mL: positron emission tomography (PET) with FDA-approved advanced imaging agent for prostate cancer (e.g. PSMA) required.
  • PSA <0.2 n/gm: PET with above noted agents OR conventional CT or MRI at investigator discretion.
  • All sexually active men must agree to use adequate contraception for the duration of study therapies and a period of 60 days thereafter. Should a female partner of a trial participant become pregnant or suspect she is pregnant while the subject is participating in this study, the patient should inform his treating physician immediately.
  • Ability to understand and the willingness to sign a written informed consent.

You cannot join if

  • Prior androgen deprivation therapy (ADT) > 3 months OR anti-androgen therapy (AAT) of > 30 days. For shorter courses of either, at least 30 day "wash out" period is required with confirmation of resolved castration of testosterone to >50ng/mL.
  • Ongoing testosterone replacement therapy (TRT) with refusal to discontinue (must be stopped with demonstration of detectable PSA ≥0.05ng/mL and non-castrate testosterone >50ng/mL after 14 days of TRT cessation)
  • Prior pelvic radiotherapy
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that, in the opinion of the investigator, would limit compliance with study requirements.
  • History of bladder neck or urethral stricture requiring procedural intervention.
  • Patients with a prior or concurrent malignancy whose natural history or treatment has the potential to actively interfere with the safety or efficacy assessments of this study in the investigator's view.
  • Active inflammatory bowel disease requiring recurring systemic or steroid/enema therapy

The treatment

How it is intended to work

This is how the treatment is meant to work. Whether it helps, and how safe it is, is what this trial is testing.

Treatments listed in the registry

  • Prostate Fossa Radiotherapy (Radiation): Stereotactic ultra hypofractionanted radiotherapy delivered to the prostate fossa using the Ethos online adaptive platform. Total dose of 32.5 Gy administered in 5 fractions over 2-4 weeks.
  • Pelvic nodal Radiotherapy (Radiation): Sequential pelvic nodal radiotherapy delivered only to PSA non responders. Dose of 25 Gy given in 5 fractions over 4 weeks using the same stereotactic technique as prostate fossa RT.
  • Androgen Deprivation Therapy (ADT) (Drug): GnRH agonist or antagonist (leuprolide, goserelin, degarelix) administered as per institutional standard. Therapy duration is 4 months, starting before or within 14 days of pelvic nodal RT initiation.

The study

Treatment groups

Na · Single Group · masking: None

Single Arm: PSA Response Adapted Salvage Radiotherapy (Experimental)

All participants initially receive prostate fossa radiotherapy (RT) using stereotactic ultra-hypofractionated dosing (32.5 Gy in 5 fractions over 2-4 weeks) delivered via the Ethos™ online adaptive platform. At approximately 5 weeks post-RT initiation, PSA response is assessed: * Responders: Patients with PSA <0.05 ng/mL or a decrease of ≥0.2 ng/mL compared to pre-RT PSA will undergo observation without further immediate therapy. * Non-Responders: Patients not meeting response criteria will receive sequential pelvic nodal RT (25 Gy in 5 fractions over ≤4 weeks) plus androgen deprivation therapy (ADT) for 4 months. Pelvic nodal RT begins within 14 days after response assessment. ADT (GnRH agonists/antagonists, e.g., leuprolide, goserelin, degarelix) will be started before or within 14 days of pelvic nodal RT initiation.

What it involves

Procedures

As the registry describes them. Requirements to join, such as a tissue sample, are in the eligibility list above even when on-study procedures are optional. Ask the study team which steps apply to you.

  • radiation: Part of the study plan

Goals

What the study measures

Main goals

  • Freedom from failure (2 years from end of radiotherapy)

Other goals

  • EPIC-26 hormonal summary domain score
  • EPIC-26 Genitourinary (GU) summary domain score
  • EPIC-26 Gastrointestinal (GI) summary domain score
  • CTCAE v5.0 toxicity GU and GI

Planned enrollment: 68 (estimated).

Where

Recruiting US sites

  • UT Southwestern Medical Center-Dallas, Dallas, Texas

Site status as of Oct 30, 2026. Check the live record before contacting a site.

Sources

Where this comes from

Registry record reviewed as fetched Oct 30, 2026, last updated by the sponsor Jun 29, 2026. Public record; not medical advice.

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