Verbetering van behandelopties in patiënten met hoog-risico en oligorecurrente prostaatkanker.

The main subject will be to search for new targeted neoadjuvant therapies against prostate cancer. There has been positive effects seen of intensification of systemic treatments in advanced prostate cancer. Therapies from the non-curative setting are moving towards the curative setting. Although hormone therapies have been moved to the neoadjuvant setting, more intensified regimens with molecular markers have not yet been investigated. This double blind, placebo-controlled randomised phase II platform trial will be the first to implement these intensified regimens prior to radical prostatectomy in the early disease space, while collecting samples for biomarker generation. The overarching idea is by early intensification more pathological responses will be observed at surgery, and thus fewer people will become incurable. The primary outcome will be to improve proportion of minimal residual disease when intensifying neoadjuvant systemic treatments. There will be many studies comparing new regimens in association with hormone therapies against the standard of care at the relevant time. The first experimental arm will receive ADT+ARTA+PARPi. As new experimental treatments are available, these will be added as new arms in the trial. In association with this first arm, we will try to define BRCAness better and in more detail. Beside this subject, there will be cooperation on many other studies in the field of oncologic urology.