Two Studies for Patients With High Risk Prostate Cancer Testing Less Intense Treatment for Patients With a Low Gene Risk Score and Testing a More Intense Treatment for Patients With a High Gene Risk Score, The PREDICT-RT Trial
Purpose
This phase III trial compares less intense hormone therapy and radiation therapy to usual hormone therapy and radiation therapy in treating patients with high risk prostate cancer and low gene risk score. This trial also compares more intense hormone therapy and radiation therapy to usual hormone therapy and radiation therapy in patients with high risk prostate cancer and high gene risk score. Apalutamide may help fight prostate cancer by blocking the use of androgen by the tumor cells. Radiation therapy uses high energy rays to kill tumor cells and shrink tumors. Giving a shorter hormone therapy treatment may work the same at controlling prostate cancer compared to the usual 24 month hormone therapy treatment in patients with low gene risk score. Adding apalutamide to the usual treatment may increase the length of time without prostate cancer spreading as compared to the usual treatment in patients with high gene risk score.
Conditions
- Metastatic Malignant Neoplasm in the Bone
- Prostate Adenocarcinoma
- Stage III Prostate Cancer AJCC v8
- Stage IIIA Prostate Cancer AJCC v8
- Stage IIIB Prostate Cancer AJCC v8
- Stage IIIC Prostate Cancer AJCC v8
- Stage IVA Prostate Cancer AJCC v8
Eligibility
- Eligible Ages
- Over 18 Years
- Eligible Genders
- Male
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- PRIOR TO STEP 1 REGISTRATION - Pathologically proven diagnosis of adenocarcinoma of prostate cancer within 180 days prior to registration - High-risk disease defined as having at least one or more of the following: - PSA > 20 ng/mL prior to starting ADT Note: Patients receiving a 5-alpha reductase inhibitor (ex. finasteride) at the time of enrollment are eligible. The baseline PSA value should be doubled for PSAs taken while on 5-alpha reductase inhibitors and the medication should be discontinued prior to randomization but a washout period is not required. - cT3a-T4 by digital exam or imaging (American Joint Committee on Cancer [AJCC] 8th edition [Ed.]) - Gleason score of 8-10 - Node positive by conventional imaging with a short axis of at least 1.0 cm - Appropriate stage for study entry based on the following diagnostic workup: - History/physical examination within 120 days prior to registration; - Bone imaging within 120 days prior to registration; - Note: To be eligible, patient must have no definitive evidence of bone metastases (M0) on bone scan or sodium fluoride (NaF) PET within 120 days prior to registration (negative NaF PET/CT or negative Axumin or choline PET or negative fluciclovine, choline or prostate-specific membrane antigen (PSMA) PET within 120 days prior to registration is an acceptable substitute if they have been performed). Patients who have bone metastases established only fluciclovine, choline, or PSMA PET but not definitive on bone scan or NaF PET will still be eligible - CT or MRI of the pelvis within 120 days prior to registration (negative fluciclovine, choline, or PSMA PET within 120 days prior to registration is an acceptable substitute). As with bone staging, nodal staging for trial purposes will be based off of conventional imaging findings only - Patients with confirmed N1 metastases on conventional imaging (CT/MRI) as defined by ≥10 mm on short axis are eligible but will be automatically assigned to the intensification study. Patients who are positive by fluciclovine, choline, or PSMA PET (i.e. N1), but whose nodes do not meet traditional size criteria for positivity (i.e. they measure ≥ 10 mm on either the CT or MRI portion of the PET or on a dedicated CT or MRI) will not be considered N1 for the trial and will not automatically be assigned to the intensification study - Age ≥ 18 - Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 within 120 days prior to registration - Hemoglobin ≥ 9.0 g/dL, independent of transfusion and/or growth factors (within 120 days prior to registration) - Platelet count ≥ -100 x 10^3/uL independent of transfusion and/or growth factors (within 120 days prior to registration) - Creatinine clearance (CrCl) ≥ 30 mL/min estimated by Cockcroft-Gault equation (within 120 days prior to registration) - For Black patients whose renal function is not considered adequate by Cockcroft-Gault formula, an alternative formula that takes race into account (Chronic Kidney Disease Epidemiology Collaboration CKD-EPI formula) may be used for calculating creatinine clearance for trial eligibility - Either a CrCl ≥ 30 ml/min or calculated glomerular filtration rate (GFR) ≥ 30 will make a patient eligible - Total bilirubin =< 1.5 x institutional upper limit of normal (ULN) (within 120 days prior to registration) - Note: In subjects with Gilbert's syndrome, if total bilirubin is > 1.5 x ULN, measure direct and indirect bilirubin and if direct bilirubin is ≤ 1.5 x ULN, subject is eligible - Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) or alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) ≤ 2.5 x institutional ULN (within 120 days prior to registration) - Serum albumin ≥ 3.0 g/dL (within 120 days prior to registration) - The patient must agree to use a condom (even men with vasectomies) and another effective method of birth control if he is having sex with a woman of childbearing potential or agree to use a condom if he is having sex with a woman who is pregnant while on study drug and for 3 months following the last dose of study drug - Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial and have a CD4 count ≥ 200 cells/microliter within 60 days prior to registration. Note: HIV testing is not required for eligibility for this protocol. Of note, for patients with HIV in the intensification trial randomized to apalutamide, highly active antiretroviral therapy (HAART) may need to be adjusted to medications that do not interact with apalutamide - For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable after or on suppressive therapy within 60 days prior to registration, if indicated. Note: HBV viral testing is not required for eligibility for this protocol - Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial. Note: Any patient with a cancer (other than keratinocyte carcinoma or carcinoma in situ or low-grade non-muscle invasive bladder cancer) who has been disease-free for less than 3 years must contact the principal investigator - The patient or a legally authorized representative must provide study-specific informed consent prior to study entry - PRIOR TO STEP 2 RANDOMIZATION - Confirmation of Decipher score - Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load within 60 days prior. Note: Apalutamide may interfere with HCV drugs. Patients on HCV medications should alert their infectious diseases physician if they get randomized to apalutamide due to the possibility that apalutamide can affect the bioavailability of some HCV medications. HCV viral testing is not required for eligibility for this protocol - For patients entering the Intensification Cohort ONLY: Patients must discontinue or substitute concomitant medications known to lower the seizure threshold at least 30 days prior to Step 2 randomization
Exclusion Criteria
- PRIOR TO STEP 1 REGISTRATION: - Definitive radiologic evidence of metastatic disease outside of the pelvic nodes (M1a, M1b or M1c) on conventional imaging (i.e. bone scan, CT scan, MRI) - Prior systemic chemotherapy within ≤ 3 years prior to registration; note that prior chemotherapy for a different cancer is allowed (completed > 3 years prior to registration - Prior radical prostatectomy - Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields - Current use of 5-alpha reductase inhibitor. NOTE: If the alpha reductase inhibitor is stopped prior to randomization the patient is eligible - History of any of the following: - Seizure disorder - Current severe or unstable angina - New York Heart Association Functional Classification III/IV (Note: Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification.) - History of any condition that in the opinion of the investigator, would preclude participation in this study - Evidence of any of the following at registration: - Active uncontrolled infection requiring IV antibiotics - Baseline severe hepatic impairment (Child Pugh Class C) - Inability to swallow oral pills - Any current condition that in the opinion of the investigator, would preclude participation in this study - Prior pharmacologic androgen ablation for prostate cancer is allowed only if the onset of androgen ablation (both luteinizing hormone-releasing hormone [LHRH] agonist and oral anti-androgen) is ≤ 60 days prior to registration; Please note: baseline PSA must be obtained prior to the start of any ADT - PRIOR TO STEP 2 RANDOMIZATION: - Evidence of known gastrointestinal disorder affecting absorption of oral medications at registration - For patients entering the Intensification Cohort ONLY: Presence of uncontrolled hypertension (persistent systolic blood pressure [BP] ≥ 160 mmHg or diastolic BP ≥ 100 mmHg). Subjects with a history of hypertension are allowed, provided that BP is controlled to within these limits by anti-hypertensive treatment
Study Design
- Phase
- Phase 3
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Primary Purpose
- Treatment
- Masking
- None (Open Label)
Arm Groups
| Arm | Description | Assigned Intervention |
|---|---|---|
|
Active Comparator Arm I (de-intensification study) |
Patients undergo RT over 2-11 weeks and receive ADT (consisting of either leuprolide, goserelin, triptorelin, degarelix, buserelin or histrelin and bicalutamide or flutamide) for 24 months in the absence of disease progression or unacceptable toxicity. |
|
|
Experimental Arm II (de-intensification study) |
Patients undergo RT over 2-11 weeks and receive ADT (consisting of either leuprolide, goserelin, triptorelin, degarelix, buserelin or histrelin and bicalutamide or flutamide) for 12 months in the absence of disease progression or unacceptable toxicity. |
|
|
Active Comparator Arm III (intensification study) |
Patients undergo RT over 2-11 weeks and receive ADT as in Arm I. |
|
|
Experimental Arm IV (intensification study) |
Patients undergo RT over 2-11 weeks and receive ADT (consisting of either leuprolide, goserelin, triptorelin, degarelix, buserelin or histrelin) for 24 months in the absence of disease progression or unacceptable toxicity. Patients also receive apalutamide PO QD. Treatment repeats every 90 days for up to 8 cycles (24 months) in the absence of disease progression or unacceptable toxicity. |
|
Recruiting Locations
Fairbanks Memorial Hospital
Fairbanks, Alaska 99701
Fairbanks, Alaska 99701
Arizona Breast Cancer Specialists-Gilbert
Gilbert, Arizona 85297
Gilbert, Arizona 85297
Contact:
Site Public Contact
480-922-4600
Site Public Contact
480-922-4600
Arizona Center for Cancer Care-Peoria
Peoria, Arizona 85381
Peoria, Arizona 85381
Contact:
Site Public Contact
623-773-2873
Site Public Contact
623-773-2873
Arizona Breast Cancer Specialists-Scottsdale
Scottsdale, Arizona 85258
Scottsdale, Arizona 85258
Contact:
Site Public Contact
480-922-4600
Site Public Contact
480-922-4600
University of Arizona Cancer Center-North Campus
Tucson, Arizona 85719
Tucson, Arizona 85719
University of Arkansas for Medical Sciences
Little Rock, Arkansas 72205
Little Rock, Arkansas 72205
Contact:
Site Public Contact
501-686-8274
Site Public Contact
501-686-8274
Sutter Cancer Centers Radiation Oncology Services-Auburn
Auburn, California 95603
Auburn, California 95603
AIS Cancer Center at San Joaquin Community Hospital
Bakersfield, California 93301
Bakersfield, California 93301
Contact:
Site Public Contact
661-323-4673
Site Public Contact
661-323-4673
City of Hope Comprehensive Cancer Center
Duarte, California 91010
Duarte, California 91010
Kaiser Permanente Dublin
Dublin, California 94568
Dublin, California 94568
Contact:
Site Public Contact
877-642-4691
Site Public Contact
877-642-4691
Kaiser Permanente-Fremont
Fremont, California 94538
Fremont, California 94538
Washington Hospital
Fremont, California 94538
Fremont, California 94538
Contact:
Site Public Contact
510-745-6433
Site Public Contact
510-745-6433
Kaiser Permanente-Fresno
Fresno, California 93720
Fresno, California 93720
Marin General Hospital
Greenbrae, California 94904
Greenbrae, California 94904
Contact:
Site Public Contact
415-925-7325
Site Public Contact
415-925-7325
City of Hope at Irvine Lennar
Irvine, California 92618
Irvine, California 92618
Contact:
Site Public Contact
877-467-3411
Site Public Contact
877-467-3411
UC San Diego Moores Cancer Center
La Jolla, California 92093
La Jolla, California 92093
City of Hope Antelope Valley
Lancaster, California 93534
Lancaster, California 93534
Cedars Sinai Medical Center
Los Angeles, California 90048
Los Angeles, California 90048
Contact:
Site Public Contact
310-423-8965
Site Public Contact
310-423-8965
Fremont - Rideout Cancer Center
Marysville, California 95901
Marysville, California 95901
Contact:
Site Public Contact
530-749-4400
Site Public Contact
530-749-4400
Memorial Medical Center
Modesto, California 95355
Modesto, California 95355
Kaiser Permanente-Modesto
Modesto, California 95356
Modesto, California 95356
Providence Queen of The Valley
Napa, California 94558
Napa, California 94558
Contact:
Site Public Contact
707-521-3830
Site Public Contact
707-521-3830
Kaiser Permanente-Oakland
Oakland, California 94611
Oakland, California 94611
Saint Joseph Hospital - Orange
Orange, California 92868
Orange, California 92868
Contact:
Site Public Contact
714-734-6220
Site Public Contact
714-734-6220
UC Irvine Health/Chao Family Comprehensive Cancer Center
Orange, California 92868
Orange, California 92868
Stanford Cancer Institute Palo Alto
Palo Alto, California 94304
Palo Alto, California 94304
Kaiser Permanente-Roseville
Roseville, California 95661
Roseville, California 95661
Sutter Cancer Centers Radiation Oncology Services-Roseville
Roseville, California 95661
Roseville, California 95661
Kaiser Permanente Downtown Commons
Sacramento, California 95814
Sacramento, California 95814
Sutter Medical Center Sacramento
Sacramento, California 95816
Sacramento, California 95816
University of California Davis Comprehensive Cancer Center
Sacramento, California 95817
Sacramento, California 95817
Contact:
Site Public Contact
916-734-3089
Site Public Contact
916-734-3089
Kaiser Permanente-South Sacramento
Sacramento, California 95823
Sacramento, California 95823
Kaiser Permanente-San Francisco
San Francisco, California 94115
San Francisco, California 94115
UCSF Medical Center-Mission Bay
San Francisco, California 94158
San Francisco, California 94158
Kaiser Permanente-Santa Teresa-San Jose
San Jose, California 95119
San Jose, California 95119
Stanford Cancer Center South Bay
San Jose, California 95124
San Jose, California 95124
Kaiser Permanente San Leandro
San Leandro, California 94577
San Leandro, California 94577
UCSF Cancer Center - San Mateo
San Mateo, California 94402
San Mateo, California 94402
Ridley-Tree Cancer Center
Santa Barbara, California 93105
Santa Barbara, California 93105
Kaiser Permanente Medical Center - Santa Clara
Santa Clara, California 95051
Santa Clara, California 95051
Kaiser Permanente-Santa Rosa
Santa Rosa, California 95403
Santa Rosa, California 95403
City of Hope South Pasadena
South Pasadena, California 91030
South Pasadena, California 91030
Kaiser Permanente-South San Francisco
South San Francisco, California 94080
South San Francisco, California 94080
Cedars-Sinai Cancer - Tarzana
Tarzana, California 91356
Tarzana, California 91356
Contact:
Site Public Contact
818-981-3818
Site Public Contact
818-981-3818
Torrance Memorial Physician Network - Cancer Care
Torrance, California 90505
Torrance, California 90505
Torrance Memorial Medical Center
Torrance, California 90509
Torrance, California 90509
Contact:
Site Public Contact
310-517-4665
Site Public Contact
310-517-4665
Gene Upshaw Memorial Tahoe Forest Cancer Center
Truckee, California 96161
Truckee, California 96161
Contact:
Site Public Contact
530-582-6450
Site Public Contact
530-582-6450
City of Hope Upland
Upland, California 91786
Upland, California 91786
Kaiser Permanente-Vallejo
Vallejo, California 94589
Vallejo, California 94589
Kaiser Permanente-Walnut Creek
Walnut Creek, California 94596
Walnut Creek, California 94596
John Muir Medical Center-Walnut Creek
Walnut Creek, California 94598
Walnut Creek, California 94598
Contact:
Site Public Contact
925-941-4246
Site Public Contact
925-941-4246
UCHealth University of Colorado Hospital
Aurora, Colorado 80045
Aurora, Colorado 80045
Contact:
Site Public Contact
720-848-0650
Site Public Contact
720-848-0650
Rocky Mountain Cancer Centers-Boulder
Boulder, Colorado 80304
Boulder, Colorado 80304
UCHealth Memorial Hospital Central
Colorado Springs, Colorado 80909
Colorado Springs, Colorado 80909
Contact:
Site Public Contact
719-365-2406
Site Public Contact
719-365-2406
Memorial Hospital North
Colorado Springs, Colorado 80920
Colorado Springs, Colorado 80920
Contact:
Site Public Contact
719-364-6700
Site Public Contact
719-364-6700
Shaw Cancer Center
Edwards, Colorado 81632
Edwards, Colorado 81632
Contact:
Site Public Contact
970-569-7429
Site Public Contact
970-569-7429
Poudre Valley Hospital
Fort Collins, Colorado 80524
Fort Collins, Colorado 80524
Contact:
Site Public Contact
970-297-6150
Site Public Contact
970-297-6150
Cancer Care and Hematology-Fort Collins
Fort Collins, Colorado 80528
Fort Collins, Colorado 80528
North Colorado Medical Center
Greeley, Colorado 80631
Greeley, Colorado 80631
UCHealth Greeley Hospital
Greeley, Colorado 80631
Greeley, Colorado 80631
UCHealth Highlands Ranch Hospital
Highlands Ranch, Colorado 80129
Highlands Ranch, Colorado 80129
Contact:
Site Public Contact
720-848-0650
Site Public Contact
720-848-0650
Medical Center of the Rockies
Loveland, Colorado 80538
Loveland, Colorado 80538
Contact:
Site Public Contact
970-203-7083
Site Public Contact
970-203-7083
McKee Medical Center
Loveland, Colorado 80539
Loveland, Colorado 80539
Hartford HealthCare - Saint Vincent's Medical Center
Bridgeport, Connecticut 06606
Bridgeport, Connecticut 06606
Contact:
Site Public Contact
860-972-4700
Site Public Contact
860-972-4700
Smilow Cancer Hospital-Derby Care Center
Derby, Connecticut 06418
Derby, Connecticut 06418
Smilow Cancer Hospital Care Center-Fairfield
Fairfield, Connecticut 06824
Fairfield, Connecticut 06824
Smilow Cancer Hospital Care Center at Greenwich
Greenwich, Connecticut 06830
Greenwich, Connecticut 06830
Smilow Cancer Hospital Care Center - Guilford
Guilford, Connecticut 06437
Guilford, Connecticut 06437
Hartford Hospital
Hartford, Connecticut 06102
Hartford, Connecticut 06102
Contact:
Site Public Contact
860-545-5363
Site Public Contact
860-545-5363
Smilow Cancer Hospital Care Center at Saint Francis
Hartford, Connecticut 06105
Hartford, Connecticut 06105
Midstate Medical Center
Meriden, Connecticut 06451
Meriden, Connecticut 06451
Contact:
Site Public Contact
866-662-5678
Site Public Contact
866-662-5678
The Hospital of Central Connecticut
New Britain, Connecticut 06050
New Britain, Connecticut 06050
Contact:
Site Public Contact
860-224-5660
Site Public Contact
860-224-5660
Yale University
New Haven, Connecticut 06520
New Haven, Connecticut 06520
Yale-New Haven Hospital North Haven Medical Center
North Haven, Connecticut 06473
North Haven, Connecticut 06473
Smilow Cancer Hospital-Orange Care Center
Orange, Connecticut 06477
Orange, Connecticut 06477
Smilow Cancer Hospital Care Center at Long Ridge
Stamford, Connecticut 06902
Stamford, Connecticut 06902
Stamford Hospital/Bennett Cancer Center
Stamford, Connecticut 06904
Stamford, Connecticut 06904
Contact:
Site Public Contact
203-323-8944
Site Public Contact
203-323-8944
Smilow Cancer Hospital Care Center-Trumbull
Trumbull, Connecticut 06611
Trumbull, Connecticut 06611
Smilow Cancer Hospital Care Center - Waterford
Waterford, Connecticut 06385
Waterford, Connecticut 06385
Bayhealth Hospital Kent Campus
Dover, Delaware 19901
Dover, Delaware 19901
Helen F Graham Cancer Center
Newark, Delaware 19713
Newark, Delaware 19713
Medical Oncology Hematology Consultants PA
Newark, Delaware 19713
Newark, Delaware 19713
Boca Raton Regional Hospital
Boca Raton, Florida 33486
Boca Raton, Florida 33486
Contact:
Site Public Contact
561-955-4800
Site Public Contact
561-955-4800
University of Florida Health Science Center - Gainesville
Gainesville, Florida 32610
Gainesville, Florida 32610
Miami Cancer Institute
Miami, Florida 33176
Miami, Florida 33176
Contact:
Site Public Contact
786-596-2000
Site Public Contact
786-596-2000
GenesisCare USA - Plantation
Plantation, Florida 33324
Plantation, Florida 33324
Tampa General Hospital
Tampa, Florida 33606
Tampa, Florida 33606
Grady Health System
Atlanta, Georgia 30303
Atlanta, Georgia 30303
Contact:
Site Public Contact
404-489-9164
Site Public Contact
404-489-9164
Emory Proton Therapy Center
Atlanta, Georgia 30308
Atlanta, Georgia 30308
Emory University Hospital Midtown
Atlanta, Georgia 30308
Atlanta, Georgia 30308
Contact:
Site Public Contact
888-946-7447
Site Public Contact
888-946-7447
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia 30322
Atlanta, Georgia 30322
Contact:
Site Public Contact
404-778-1868
Site Public Contact
404-778-1868
Emory Saint Joseph's Hospital
Atlanta, Georgia 30342
Atlanta, Georgia 30342
Contact:
Site Public Contact
404-851-7115
Site Public Contact
404-851-7115
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
Savannah, Georgia 31405
Savannah, Georgia 31405
Rush - Copley Medical Center
Aurora, Illinois 60504
Aurora, Illinois 60504
Advocate Good Shepherd Hospital
Barrington, Illinois 60010
Barrington, Illinois 60010
Contact:
Site Public Contact
847-842-4847
Site Public Contact
847-842-4847
Illinois CancerCare-Bloomington
Bloomington, Illinois 61704
Bloomington, Illinois 61704
Illinois CancerCare-Canton
Canton, Illinois 61520
Canton, Illinois 61520
Illinois CancerCare-Carthage
Carthage, Illinois 62321
Carthage, Illinois 62321
Northwestern University
Chicago, Illinois 60611
Chicago, Illinois 60611
Rush University Medical Center
Chicago, Illinois 60612
Chicago, Illinois 60612
University of Illinois
Chicago, Illinois 60612
Chicago, Illinois 60612
Contact:
Site Public Contact
312-355-3046
Site Public Contact
312-355-3046
University of Chicago Comprehensive Cancer Center
Chicago, Illinois 60637
Chicago, Illinois 60637
Advocate Illinois Masonic Medical Center
Chicago, Illinois 60657
Chicago, Illinois 60657
Contact:
Site Public Contact
773-296-5360
Site Public Contact
773-296-5360
AMG Crystal Lake - Oncology
Crystal Lake, Illinois 60014
Crystal Lake, Illinois 60014
Carle at The Riverfront
Danville, Illinois 61832
Danville, Illinois 61832
Decatur Memorial Hospital
Decatur, Illinois 62526
Decatur, Illinois 62526
Northwestern Medicine Cancer Center Kishwaukee
DeKalb, Illinois 60115
DeKalb, Illinois 60115
Advocate Good Samaritan Hospital
Downers Grove, Illinois 60515
Downers Grove, Illinois 60515
Crossroads Cancer Center
Effingham, Illinois 62401
Effingham, Illinois 62401
Advocate Sherman Hospital
Elgin, Illinois 60123
Elgin, Illinois 60123
Contact:
Site Public Contact
847-429-2907
Site Public Contact
847-429-2907
Elmhurst Memorial Hospital
Elmhurst, Illinois 60126
Elmhurst, Illinois 60126
Illinois CancerCare-Eureka
Eureka, Illinois 61530
Eureka, Illinois 61530
Illinois CancerCare-Galesburg
Galesburg, Illinois 61401
Galesburg, Illinois 61401
Northwestern Medicine Cancer Center Delnor
Geneva, Illinois 60134
Geneva, Illinois 60134
Advocate South Suburban Hospital
Hazel Crest, Illinois 60429
Hazel Crest, Illinois 60429
Contact:
Site Public Contact
708-799-9995
Site Public Contact
708-799-9995
Illinois CancerCare-Kewanee Clinic
Kewanee, Illinois 61443
Kewanee, Illinois 61443
Northwestern Medicine Lake Forest Hospital
Lake Forest, Illinois 60045
Lake Forest, Illinois 60045
AMG Libertyville - Oncology
Libertyville, Illinois 60048
Libertyville, Illinois 60048
Condell Memorial Hospital
Libertyville, Illinois 60048
Libertyville, Illinois 60048
Illinois CancerCare-Macomb
Macomb, Illinois 61455
Macomb, Illinois 61455
Carle Physician Group-Mattoon/Charleston
Mattoon, Illinois 61938
Mattoon, Illinois 61938
Loyola University Medical Center
Maywood, Illinois 60153
Maywood, Illinois 60153
Contact:
Site Public Contact
708-226-4357
Site Public Contact
708-226-4357
Edward Hospital/Cancer Center
Naperville, Illinois 60540
Naperville, Illinois 60540
Contact:
Site Public Contact
630-646-6075
Site Public Contact
630-646-6075
UC Comprehensive Cancer Center at Silver Cross
New Lenox, Illinois 60451
New Lenox, Illinois 60451
Advocate Christ Medical Center
Oak Lawn, Illinois 60453-2699
Oak Lawn, Illinois 60453-2699
Contact:
Site Public Contact
800-323-8622
Site Public Contact
800-323-8622
University of Chicago Medicine-Orland Park
Orland Park, Illinois 60462
Orland Park, Illinois 60462
Illinois CancerCare-Ottawa Clinic
Ottawa, Illinois 61350
Ottawa, Illinois 61350
Advocate Lutheran General Hospital
Park Ridge, Illinois 60068
Park Ridge, Illinois 60068
Contact:
Site Public Contact
847-384-3621
Site Public Contact
847-384-3621
Illinois CancerCare-Pekin
Pekin, Illinois 61554
Pekin, Illinois 61554
Illinois CancerCare-Peoria
Peoria, Illinois 61615
Peoria, Illinois 61615
Methodist Medical Center of Illinois
Peoria, Illinois 61636
Peoria, Illinois 61636
OSF Saint Francis Medical Center
Peoria, Illinois 61637
Peoria, Illinois 61637
Illinois CancerCare-Peru
Peru, Illinois 61354
Peru, Illinois 61354
Illinois CancerCare-Princeton
Princeton, Illinois 61356
Princeton, Illinois 61356
SwedishAmerican Regional Cancer Center/ACT
Rockford, Illinois 61114
Rockford, Illinois 61114
Memorial Hospital East
Shiloh, Illinois 62269
Shiloh, Illinois 62269
Memorial Medical Center
Springfield, Illinois 62781
Springfield, Illinois 62781
Carle Cancer Center
Urbana, Illinois 61801
Urbana, Illinois 61801
Northwestern Medicine Cancer Center Warrenville
Warrenville, Illinois 60555
Warrenville, Illinois 60555
Illinois CancerCare - Washington
Washington, Illinois 61571
Washington, Illinois 61571
Saint Luke's Hospital
Cedar Rapids, Iowa 52402
Cedar Rapids, Iowa 52402
Mercy Hospital
Cedar Rapids, Iowa 52403
Cedar Rapids, Iowa 52403
Contact:
Site Public Contact
319-365-4673
Site Public Contact
319-365-4673
Oncology Associates at Mercy Medical Center
Cedar Rapids, Iowa 52403
Cedar Rapids, Iowa 52403
Contact:
Site Public Contact
319-363-2690
Site Public Contact
319-363-2690
Iowa Methodist Medical Center
Des Moines, Iowa 50309
Des Moines, Iowa 50309
Contact:
Site Public Contact
515-241-6727
Site Public Contact
515-241-6727
Medical Oncology and Hematology Associates-Des Moines
Des Moines, Iowa 50309
Des Moines, Iowa 50309
Contact:
Site Public Contact
515-241-3305
Site Public Contact
515-241-3305
Broadlawns Medical Center
Des Moines, Iowa 50314
Des Moines, Iowa 50314
Contact:
Site Public Contact
515-282-2200
Site Public Contact
515-282-2200
University of Kansas Cancer Center
Kansas City, Kansas 66160
Kansas City, Kansas 66160
Olathe Health Cancer Center
Olathe, Kansas 66061
Olathe, Kansas 66061
University of Kansas Cancer Center-Overland Park
Overland Park, Kansas 66210
Overland Park, Kansas 66210
Salina Regional Health Center
Salina, Kansas 67401
Salina, Kansas 67401
University of Kansas Health System Saint Francis Campus
Topeka, Kansas 66606
Topeka, Kansas 66606
Contact:
Site Public Contact
785-295-8000
Site Public Contact
785-295-8000
University of Kansas Hospital-Westwood Cancer Center
Westwood, Kansas 66205
Westwood, Kansas 66205
Ascension Via Christi Hospitals Wichita
Wichita, Kansas 67214
Wichita, Kansas 67214
Saint Joseph Hospital East
Lexington, Kentucky 40509
Lexington, Kentucky 40509
LSU Healthcare Network / Metairie Multi-Specialty Clinic
Metairie, Louisiana 70006
Metairie, Louisiana 70006
Tulane University School of Medicine
New Orleans, Louisiana 70112
New Orleans, Louisiana 70112
MaineHealth Coastal Cancer Treatment Center
Bath, Maine 04530
Bath, Maine 04530
Maine Medical Center-Bramhall Campus
Portland, Maine 04102
Portland, Maine 04102
Contact:
Site Public Contact
207-885-7565
Site Public Contact
207-885-7565
Penobscot Bay Medical Center
Rockport, Maine 04856
Rockport, Maine 04856
MaineHealth Cancer Care Center of York County
Sanford, Maine 04073
Sanford, Maine 04073
Contact:
Site Public Contact
207-459-1600
Site Public Contact
207-459-1600
Maine Medical Center- Scarborough Campus
Scarborough, Maine 04074
Scarborough, Maine 04074
Maine Medical Partners - South Portland
South Portland, Maine 04106
South Portland, Maine 04106
Anne Arundel Medical Center
Annapolis, Maryland 21401
Annapolis, Maryland 21401
Maryland Proton Treatment Center
Baltimore, Maryland 21201
Baltimore, Maryland 21201
University of Maryland/Greenebaum Cancer Center
Baltimore, Maryland 21201
Baltimore, Maryland 21201
Contact:
Site Public Contact
800-888-8823
Site Public Contact
800-888-8823
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland 21287
Baltimore, Maryland 21287
UM Upper Chesapeake Medical Center
Bel Air, Maryland 21014
Bel Air, Maryland 21014
Contact:
Site Public Contact
443-643-3010
Site Public Contact
443-643-3010
Suburban Hospital
Bethesda, Maryland 20814
Bethesda, Maryland 20814
University of Maryland Shore Medical Center at Easton
Easton, Maryland 21601
Easton, Maryland 21601
Massachusetts General Hospital Cancer Center
Boston, Massachusetts 02114
Boston, Massachusetts 02114
Contact:
Site Public Contact
877-726-5130
Site Public Contact
877-726-5130
Dana-Farber Cancer Institute
Boston, Massachusetts 02215
Boston, Massachusetts 02215
Contact:
Site Public Contact
877-442-3324
Site Public Contact
877-442-3324
Dana-Farber/Brigham and Women's Cancer Center at Milford Regional
Milford, Massachusetts 01757
Milford, Massachusetts 01757
Contact:
Site Public Contact
877-332-4294
Site Public Contact
877-332-4294
Dana-Farber/Brigham and Women's Cancer Center at South Shore
South Weymouth, Massachusetts 02190
South Weymouth, Massachusetts 02190
Contact:
Site Public Contact
781-624-5000
Site Public Contact
781-624-5000
Saint Joseph Mercy Hospital
Ann Arbor, Michigan 48106
Ann Arbor, Michigan 48106
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan 48109
Ann Arbor, Michigan 48109
Contact:
Site Public Contact
800-865-1125
Site Public Contact
800-865-1125
McLaren Cancer Institute-Bay City
Bay City, Michigan 48706
Bay City, Michigan 48706
Saint Joseph Mercy Brighton
Brighton, Michigan 48114
Brighton, Michigan 48114
Trinity Health IHA Medical Group Hematology Oncology - Brighton
Brighton, Michigan 48114
Brighton, Michigan 48114
University of Michigan - Brighton Center for Specialty Care
Brighton, Michigan 48116
Brighton, Michigan 48116
Contact:
Site Public Contact
800-865-1125
Site Public Contact
800-865-1125
Saint Joseph Mercy Canton
Canton, Michigan 48188
Canton, Michigan 48188
Trinity Health IHA Medical Group Hematology Oncology - Canton
Canton, Michigan 48188
Canton, Michigan 48188
Saint Joseph Mercy Chelsea
Chelsea, Michigan 48118
Chelsea, Michigan 48118
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital
Chelsea, Michigan 48118
Chelsea, Michigan 48118
McLaren Cancer Institute-Clarkston
Clarkston, Michigan 48346
Clarkston, Michigan 48346
Michigan Healthcare Professionals Clarkston
Clarkston, Michigan 48346
Clarkston, Michigan 48346
Henry Ford Macomb Hospital-Clinton Township
Clinton Township, Michigan 48038
Clinton Township, Michigan 48038
Beaumont Hospital - Dearborn
Dearborn, Michigan 48124
Dearborn, Michigan 48124
Contact:
Site Public Contact
248-551-7695
Site Public Contact
248-551-7695
Wayne State University/Karmanos Cancer Institute
Detroit, Michigan 48201
Detroit, Michigan 48201
Henry Ford Hospital
Detroit, Michigan 48202
Detroit, Michigan 48202
Michigan Healthcare Professionals Farmington
Farmington Hills, Michigan 48334
Farmington Hills, Michigan 48334
Weisberg Cancer Treatment Center
Farmington Hills, Michigan 48334
Farmington Hills, Michigan 48334
McLaren Cancer Institute-Flint
Flint, Michigan 48532
Flint, Michigan 48532
Spectrum Health at Butterworth Campus
Grand Rapids, Michigan 49503
Grand Rapids, Michigan 49503
Trinity Health Grand Rapids Hospital
Grand Rapids, Michigan 49503
Grand Rapids, Michigan 49503
Bronson Methodist Hospital
Kalamazoo, Michigan 49007
Kalamazoo, Michigan 49007
West Michigan Cancer Center
Kalamazoo, Michigan 49007
Kalamazoo, Michigan 49007
Karmanos Cancer Institute at McLaren Greater Lansing
Lansing, Michigan 48910
Lansing, Michigan 48910
Sparrow Hospital
Lansing, Michigan 48912
Lansing, Michigan 48912
Contact:
Site Public Contact
517-364-9400
Site Public Contact
517-364-9400
McLaren Cancer Institute-Lapeer Region
Lapeer, Michigan 48446
Lapeer, Michigan 48446
Trinity Health Saint Mary Mercy Livonia Hospital
Livonia, Michigan 48154
Livonia, Michigan 48154
Michigan Healthcare Professionals Macomb
Macomb, Michigan 48044
Macomb, Michigan 48044
Michigan Healthcare Professionals Madison Heights
Madison Heights, Michigan 48071
Madison Heights, Michigan 48071
McLaren Cancer Institute-Macomb
Mount Clemens, Michigan 48043
Mount Clemens, Michigan 48043
McLaren-Port Huron
Port Huron, Michigan 48060
Port Huron, Michigan 48060
William Beaumont Hospital-Royal Oak
Royal Oak, Michigan 48073
Royal Oak, Michigan 48073
Contact:
Site Public Contact
248-551-7695
Site Public Contact
248-551-7695
Ascension Saint Mary's Hospital
Saginaw, Michigan 48601
Saginaw, Michigan 48601
Marie Yeager Cancer Center
Saint Joseph, Michigan 49085
Saint Joseph, Michigan 49085
Munson Medical Center
Traverse City, Michigan 49684
Traverse City, Michigan 49684
William Beaumont Hospital - Troy
Troy, Michigan 48085
Troy, Michigan 48085
Contact:
Site Public Contact
248-551-7695
Site Public Contact
248-551-7695
GenesisCare USA - Troy
Troy, Michigan 48098
Troy, Michigan 48098
Henry Ford West Bloomfield Hospital
West Bloomfield, Michigan 48322
West Bloomfield, Michigan 48322
University of Michigan Health - West
Wyoming, Michigan 49519
Wyoming, Michigan 49519
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus
Ypsilanti, Michigan 48197
Ypsilanti, Michigan 48197
Mercy Hospital
Coon Rapids, Minnesota 55433
Coon Rapids, Minnesota 55433
Miller-Dwan Hospital
Duluth, Minnesota 55805
Duluth, Minnesota 55805
Abbott-Northwestern Hospital
Minneapolis, Minnesota 55407
Minneapolis, Minnesota 55407
Hennepin County Medical Center
Minneapolis, Minnesota 55415
Minneapolis, Minnesota 55415
Monticello Cancer Center
Monticello, Minnesota 55362
Monticello, Minnesota 55362
Mayo Clinic in Rochester
Rochester, Minnesota 55905
Rochester, Minnesota 55905
Contact:
Site Public Contact
855-776-0015
Site Public Contact
855-776-0015
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park, Minnesota 55416
Saint Louis Park, Minnesota 55416
Regions Hospital
Saint Paul, Minnesota 55101
Saint Paul, Minnesota 55101
University of Mississippi Medical Center
Jackson, Mississippi 39216
Jackson, Mississippi 39216
Contact:
Site Public Contact
601-815-6700
Site Public Contact
601-815-6700
Saint Francis Medical Center
Cape Girardeau, Missouri 63703
Cape Girardeau, Missouri 63703
MU Health - University Hospital/Ellis Fischel Cancer Center
Columbia, Missouri 65212
Columbia, Missouri 65212
Contact:
Site Public Contact
573-882-7440
Site Public Contact
573-882-7440
Siteman Cancer Center at West County Hospital
Creve Coeur, Missouri 63141
Creve Coeur, Missouri 63141
Freeman Health System
Joplin, Missouri 64804
Joplin, Missouri 64804
University of Kansas Cancer Center - North
Kansas City, Missouri 64154
Kansas City, Missouri 64154
University of Kansas Cancer Center - Lee's Summit
Lee's Summit, Missouri 64064
Lee's Summit, Missouri 64064
University of Kansas Cancer Center at North Kansas City Hospital
North Kansas City, Missouri 64116
North Kansas City, Missouri 64116
Delbert Day Cancer Institute at PCRMC
Rolla, Missouri 65401
Rolla, Missouri 65401
Washington University School of Medicine
Saint Louis, Missouri 63110
Saint Louis, Missouri 63110
Siteman Cancer Center-South County
Saint Louis, Missouri 63129
Saint Louis, Missouri 63129
Missouri Baptist Medical Center
Saint Louis, Missouri 63131
Saint Louis, Missouri 63131
Contact:
Site Public Contact
314-996-5569
Site Public Contact
314-996-5569
Siteman Cancer Center at Christian Hospital
Saint Louis, Missouri 63136
Saint Louis, Missouri 63136
Siteman Cancer Center at Saint Peters Hospital
Saint Peters, Missouri 63376
Saint Peters, Missouri 63376
Mercy Hospital Springfield
Springfield, Missouri 65804
Springfield, Missouri 65804
Contact:
Site Public Contact
417-269-4520
Site Public Contact
417-269-4520
Billings Clinic Cancer Center
Billings, Montana 59101
Billings, Montana 59101
Benefis Healthcare- Sletten Cancer Institute
Great Falls, Montana 59405
Great Falls, Montana 59405
Nebraska Medicine-Bellevue
Bellevue, Nebraska 68123
Bellevue, Nebraska 68123
Nebraska Medicine-Village Pointe
Omaha, Nebraska 68118
Omaha, Nebraska 68118
Contact:
Site Public Contact
402-559-5600
Site Public Contact
402-559-5600
University of Nebraska Medical Center
Omaha, Nebraska 68198
Omaha, Nebraska 68198
New Hampshire Oncology Hematology PA-Concord
Concord, New Hampshire 03301
Concord, New Hampshire 03301
Contact:
Site Public Contact
603-224-2556
Site Public Contact
603-224-2556
Exeter Hospital
Exeter, New Hampshire 03833
Exeter, New Hampshire 03833
Contact:
Site Public Contact
800-439-3837
Site Public Contact
800-439-3837
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
Lebanon, New Hampshire 03756
Lebanon, New Hampshire 03756
Solinsky Center for Cancer Care
Manchester, New Hampshire 03103
Manchester, New Hampshire 03103
Contact:
Site Public Contact
800-339-6484
Site Public Contact
800-339-6484
Cooper Hospital University Medical Center
Camden, New Jersey 08103
Camden, New Jersey 08103
Contact:
Site Public Contact
856-325-6757
Site Public Contact
856-325-6757
AtlantiCare Surgery Center
Egg Harbor Township, New Jersey 08234
Egg Harbor Township, New Jersey 08234
Contact:
Site Public Contact
609-748-7200
Site Public Contact
609-748-7200
The Cancer Institute of New Jersey Hamilton
Hamilton, New Jersey 08690
Hamilton, New Jersey 08690
Contact:
Site Public Contact
609-631-6946
Site Public Contact
609-631-6946
Saint Barnabas Medical Center
Livingston, New Jersey 07039
Livingston, New Jersey 07039
Rutgers Cancer Institute of New Jersey
New Brunswick, New Jersey 08903
New Brunswick, New Jersey 08903
Contact:
Site Public Contact
732-235-7356
Site Public Contact
732-235-7356
Rutgers New Jersey Medical School
Newark, New Jersey 07101
Newark, New Jersey 07101
Contact:
Site Public Contact
732-235-7356
Site Public Contact
732-235-7356
The Valley Hospital-Luckow Pavilion
Paramus, New Jersey 07652
Paramus, New Jersey 07652
Contact:
Site Public Contact
201-634-5792
Site Public Contact
201-634-5792
Valley Hospital
Ridgewood, New Jersey 07450
Ridgewood, New Jersey 07450
Robert Wood Johnson University Hospital Somerset
Somerville, New Jersey 08876
Somerville, New Jersey 08876
Community Medical Center
Toms River, New Jersey 08755
Toms River, New Jersey 08755
MD Anderson Cancer Center at Cooper-Voorhees
Voorhees, New Jersey 08043
Voorhees, New Jersey 08043
Contact:
Site Public Contact
856-325-6757
Site Public Contact
856-325-6757
Lovelace Medical Center-Saint Joseph Square
Albuquerque, New Mexico 87102
Albuquerque, New Mexico 87102
University of New Mexico Cancer Center
Albuquerque, New Mexico 87102
Albuquerque, New Mexico 87102
Presbyterian Kaseman Hospital
Albuquerque, New Mexico 87110
Albuquerque, New Mexico 87110
Presbyterian Rust Medical Center/Jorgensen Cancer Center
Rio Rancho, New Mexico 87124
Rio Rancho, New Mexico 87124
Northwell Health Imbert Cancer Center
Bay Shore, New York 11706
Bay Shore, New York 11706
Contact:
Site Public Contact
516-734-8896
Site Public Contact
516-734-8896
New York-Presbyterian/Brooklyn Methodist Hospital
Brooklyn, New York 11215
Brooklyn, New York 11215
Roswell Park Cancer Institute
Buffalo, New York 14263
Buffalo, New York 14263
The New York Hospital Medical Center of Queens
Flushing, New York 11355
Flushing, New York 11355
Northwell Health Physicians Partners Radiation Medicine at Queens
Forest Hills, New York 11375
Forest Hills, New York 11375
Contact:
Site Public Contact
718-520-6620
Site Public Contact
718-520-6620
Glens Falls Hospital
Glens Falls, New York 12801
Glens Falls, New York 12801
Contact:
Site Public Contact
518-926-6700
Site Public Contact
518-926-6700
Northwell Health/Center for Advanced Medicine
Lake Success, New York 11042
Lake Success, New York 11042
Contact:
Site Public Contact
516-734-8896
Site Public Contact
516-734-8896
Lenox Hill Hospital
New York, New York 10021
New York, New York 10021
Contact:
Site Public Contact
516-734-8896
Site Public Contact
516-734-8896
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York, New York 10032
New York, New York 10032
Manhattan Eye Ear and Throat Hospital
New York, New York 10065
New York, New York 10065
Contact:
Site Public Contact
212-434-4460
Site Public Contact
212-434-4460
NYP/Weill Cornell Medical Center
New York, New York 10065
New York, New York 10065
Contact:
Site Public Contact
212-746-1848
Site Public Contact
212-746-1848
Queens Cancer Center
Rego Park, New York 11374
Rego Park, New York 11374
Contact:
Site Public Contact
718-312-3446
Site Public Contact
718-312-3446
University of Rochester
Rochester, New York 14642
Rochester, New York 14642
Contact:
Site Public Contact
585-275-5830
Site Public Contact
585-275-5830
Phelps Memorial Hospital Center
Sleepy Hollow, New York 10591
Sleepy Hollow, New York 10591
Contact:
Site Public Contact
914-366-1600
Site Public Contact
914-366-1600
Stony Brook University Medical Center
Stony Brook, New York 11794
Stony Brook, New York 11794
Contact:
Site Public Contact
800-862-2215
Site Public Contact
800-862-2215
State University of New York Upstate Medical University
Syracuse, New York 13210
Syracuse, New York 13210
Contact:
Site Public Contact
315-464-5476
Site Public Contact
315-464-5476
Westchester Medical Center
Valhalla, New York 10595
Valhalla, New York 10595
Wilmot Cancer Institute at Webster
Webster, New York 14580
Webster, New York 14580
Carolinas Medical Center/Levine Cancer Institute
Charlotte, North Carolina 28203
Charlotte, North Carolina 28203
Contact:
Site Public Contact
800-804-9376
Site Public Contact
800-804-9376
Novant Health Presbyterian Medical Center
Charlotte, North Carolina 28204
Charlotte, North Carolina 28204
Atrium Health Pineville/LCI-Pineville
Charlotte, North Carolina 28210
Charlotte, North Carolina 28210
Contact:
Site Public Contact
980-442-2000
Site Public Contact
980-442-2000
Atrium Health University City/LCI-University
Charlotte, North Carolina 28262
Charlotte, North Carolina 28262
Contact:
Site Public Contact
800-804-9376
Site Public Contact
800-804-9376
Levine Cancer Institute-Ballantyne
Charlotte, North Carolina 28277
Charlotte, North Carolina 28277
Contact:
Site Public Contact
800-804-9376
Site Public Contact
800-804-9376
Atrium Health Cabarrus/LCI-Concord
Concord, North Carolina 28025
Concord, North Carolina 28025
Contact:
Site Public Contact
800-804-9376
Site Public Contact
800-804-9376
Durham VA Medical Center
Durham, North Carolina 27705
Durham, North Carolina 27705
Duke University Medical Center
Durham, North Carolina 27710
Durham, North Carolina 27710
Contact:
Site Public Contact
888-275-3853
Site Public Contact
888-275-3853
Novant Health Cancer Institute - Huntersville
Huntersville, North Carolina 28078
Huntersville, North Carolina 28078
Novant Health Cancer Institute - Matthews
Matthews, North Carolina 28105
Matthews, North Carolina 28105
Atrium Health Union/LCI-Union
Monroe, North Carolina 28112
Monroe, North Carolina 28112
Contact:
Site Public Contact
980-442-2000
Site Public Contact
980-442-2000
Novant Health Cancer Institute - Mooresville
Mooresville, North Carolina 28117
Mooresville, North Carolina 28117
UNC Rex Healthcare
Raleigh, North Carolina 27607
Raleigh, North Carolina 27607
Duke Raleigh Hospital
Raleigh, North Carolina 27609
Raleigh, North Carolina 27609
Contact:
Site Public Contact
919-862-5400
Site Public Contact
919-862-5400
UNC Rex Cancer Center of Wakefield
Raleigh, North Carolina 27614
Raleigh, North Carolina 27614
Novant Cancer Institute Radiation Oncology - Supply
Supply, North Carolina 28462
Supply, North Carolina 28462
Contact:
Site Public Contact
910-754-4716
Site Public Contact
910-754-4716
Novant Health Cancer Institute Radiation Oncology - Wilmington
Wilmington, North Carolina 28401
Wilmington, North Carolina 28401
Contact:
Site Public Contact
910-251-1839
Site Public Contact
910-251-1839
Novant Health New Hanover Regional Medical Center
Wilmington, North Carolina 28401
Wilmington, North Carolina 28401
Contact:
Site Public Contact
910-342-3000
Site Public Contact
910-342-3000
Novant Health Forsyth Medical Center
Winston-Salem, North Carolina 27103
Winston-Salem, North Carolina 27103
Wake Forest University Health Sciences
Winston-Salem, North Carolina 27157
Winston-Salem, North Carolina 27157
Contact:
Site Public Contact
336-713-6771
Site Public Contact
336-713-6771
Altru Cancer Center
Grand Forks, North Dakota 58201
Grand Forks, North Dakota 58201
Contact:
Site Public Contact
701-780-6520
Site Public Contact
701-780-6520
Summa Health System - Akron Campus
Akron, Ohio 44304
Akron, Ohio 44304
Cleveland Clinic Akron General
Akron, Ohio 44307
Akron, Ohio 44307
Summa Health System - Barberton Campus
Barberton, Ohio 44203
Barberton, Ohio 44203
Ohio State University Comprehensive Cancer Center
Columbus, Ohio 43210
Columbus, Ohio 43210
Summa Health Medina Medical Center
Medina, Ohio 44256
Medina, Ohio 44256
ProMedica Flower Hospital
Sylvania, Ohio 43560
Sylvania, Ohio 43560
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma 73104
Oklahoma City, Oklahoma 73104
Legacy Mount Hood Medical Center
Gresham, Oregon 97030
Gresham, Oregon 97030
Contact:
Site Public Contact
503-413-2150
Site Public Contact
503-413-2150
Legacy Good Samaritan Hospital and Medical Center
Portland, Oregon 97210
Portland, Oregon 97210
Legacy Meridian Park Hospital
Tualatin, Oregon 97062
Tualatin, Oregon 97062
Contact:
Site Public Contact
503-413-1742
Site Public Contact
503-413-1742
Saint Luke's Cancer Center - Allentown
Allentown, Pennsylvania 18104
Allentown, Pennsylvania 18104
Contact:
Site Public Contact
610-776-4714
Site Public Contact
610-776-4714
UPMC Altoona
Altoona, Pennsylvania 16601
Altoona, Pennsylvania 16601
UPMC-Heritage Valley Health System Beaver
Beaver, Pennsylvania 15009
Beaver, Pennsylvania 15009
Saint Luke's University Hospital-Bethlehem Campus
Bethlehem, Pennsylvania 18015
Bethlehem, Pennsylvania 18015
Contact:
Site Public Contact
484-503-4151
Site Public Contact
484-503-4151
Crozer-Keystone Regional Cancer Center at Broomall
Broomall, Pennsylvania 19008
Broomall, Pennsylvania 19008
Carlisle Regional Cancer Center
Carlisle, Pennsylvania 17015
Carlisle, Pennsylvania 17015
Christiana Care Health System-Concord Health Center
Chadds Ford, Pennsylvania 19317
Chadds Ford, Pennsylvania 19317
Chambersburg Hospital
Chambersburg, Pennsylvania 17201
Chambersburg, Pennsylvania 17201
Geisinger Medical Center
Danville, Pennsylvania 17822
Danville, Pennsylvania 17822
Delaware County Memorial Hospital
Drexel Hill, Pennsylvania 19026
Drexel Hill, Pennsylvania 19026
Saint Luke's Hospital-Anderson Campus
Easton, Pennsylvania 18045
Easton, Pennsylvania 18045
Ephrata Cancer Center
Ephrata, Pennsylvania 17522
Ephrata, Pennsylvania 17522
Contact:
Site Public Contact
717-721-4840
Site Public Contact
717-721-4840
UPMC Hillman Cancer Center Erie
Erie, Pennsylvania 16505
Erie, Pennsylvania 16505
Saint Vincent Hospital
Erie, Pennsylvania 16544
Erie, Pennsylvania 16544
Contact:
Site Public Contact
814-452-5000
Site Public Contact
814-452-5000
UPMC Cancer Center at UPMC Horizon
Farrell, Pennsylvania 16121
Farrell, Pennsylvania 16121
Adams Cancer Center
Gettysburg, Pennsylvania 17325
Gettysburg, Pennsylvania 17325
Contact:
Site Public Contact
877-441-7957
Site Public Contact
877-441-7957
Crozer Regional Cancer Center at Brinton Lake
Glen Mills, Pennsylvania 19342
Glen Mills, Pennsylvania 19342
Contact:
Site Public Contact
610-284-8237
Site Public Contact
610-284-8237
UPMC Cancer Centers - Arnold Palmer Pavilion
Greensburg, Pennsylvania 15601
Greensburg, Pennsylvania 15601
Contact:
Site Public Contact
724-838-1900
Site Public Contact
724-838-1900
UPMC Pinnacle Cancer Center/Community Osteopathic Campus
Harrisburg, Pennsylvania 17109
Harrisburg, Pennsylvania 17109
Penn State Milton S Hershey Medical Center
Hershey, Pennsylvania 17033-0850
Hershey, Pennsylvania 17033-0850
IRMC Cancer Center
Indiana, Pennsylvania 15701
Indiana, Pennsylvania 15701
Jefferson Hospital
Jefferson Hills, Pennsylvania 15025
Jefferson Hills, Pennsylvania 15025
UPMC-Johnstown/John P. Murtha Regional Cancer Center
Johnstown, Pennsylvania 15901
Johnstown, Pennsylvania 15901
Contact:
Site Public Contact
814-534-4724
Site Public Contact
814-534-4724
Sechler Family Cancer Center
Lebanon, Pennsylvania 17042
Lebanon, Pennsylvania 17042
Geisinger Medical Oncology-Lewisburg
Lewisburg, Pennsylvania 17837
Lewisburg, Pennsylvania 17837
Yolanda G Barco Oncology Institute
Meadville, Pennsylvania 16335
Meadville, Pennsylvania 16335
UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
Mechanicsburg, Pennsylvania 17050
Mechanicsburg, Pennsylvania 17050
Forbes Hospital
Monroeville, Pennsylvania 15146
Monroeville, Pennsylvania 15146
Contact:
Site Public Contact
412-858-7746
Site Public Contact
412-858-7746
UPMC Cancer Center - Monroeville
Monroeville, Pennsylvania 15146
Monroeville, Pennsylvania 15146
UPMC Hillman Cancer Center in Coraopolis
Moon, Pennsylvania 15108
Moon, Pennsylvania 15108
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania 19107
Philadelphia, Pennsylvania 19107
Temple University Hospital
Philadelphia, Pennsylvania 19140
Philadelphia, Pennsylvania 19140
Contact:
Site Public Contact
215-728-2983
Site Public Contact
215-728-2983
Allegheny General Hospital
Pittsburgh, Pennsylvania 15212
Pittsburgh, Pennsylvania 15212
Contact:
Site Public Contact
877-284-2000
Site Public Contact
877-284-2000
UPMC-Magee Womens Hospital
Pittsburgh, Pennsylvania 15213
Pittsburgh, Pennsylvania 15213
Contact:
Site Public Contact
412-647-2811
Site Public Contact
412-647-2811
UPMC-Saint Margaret
Pittsburgh, Pennsylvania 15215
Pittsburgh, Pennsylvania 15215
Contact:
Site Public Contact
412-784-4900
Site Public Contact
412-784-4900
West Penn Hospital
Pittsburgh, Pennsylvania 15224
Pittsburgh, Pennsylvania 15224
Contact:
Site Public Contact
412-578-5000
Site Public Contact
412-578-5000
University of Pittsburgh Cancer Institute (UPCI)
Pittsburgh, Pennsylvania 15232
Pittsburgh, Pennsylvania 15232
Contact:
Site Public Contact
412-647-8073
Site Public Contact
412-647-8073
UPMC-Shadyside Hospital
Pittsburgh, Pennsylvania 15232
Pittsburgh, Pennsylvania 15232
Contact:
Site Public Contact
412-621-2334
Site Public Contact
412-621-2334
UPMC-Passavant Hospital
Pittsburgh, Pennsylvania 15237
Pittsburgh, Pennsylvania 15237
Contact:
Site Public Contact
412-367-6454
Site Public Contact
412-367-6454
UPMC-Saint Clair Hospital Cancer Center
Pittsburgh, Pennsylvania 15243
Pittsburgh, Pennsylvania 15243
Contact:
Site Public Contact
412-502-3920
Site Public Contact
412-502-3920
Geisinger Cancer Services-Pottsville
Pottsville, Pennsylvania 17901
Pottsville, Pennsylvania 17901
Saint Luke's Hospital - Upper Bucks Campus
Quakertown, Pennsylvania 18951
Quakertown, Pennsylvania 18951
Contact:
Site Public Contact
610-776-4714
Site Public Contact
610-776-4714
Saint Luke's Hospital-Quakertown Campus
Quakertown, Pennsylvania 18951
Quakertown, Pennsylvania 18951
Contact:
Site Public Contact
610-776-4714
Site Public Contact
610-776-4714
UPMC Cancer Center at UPMC Northwest
Seneca, Pennsylvania 16346
Seneca, Pennsylvania 16346
Contact:
Site Public Contact
814-676-7900
Site Public Contact
814-676-7900
Saint Luke's Hospital - Monroe Campus
Stroudsburg, Pennsylvania 18360
Stroudsburg, Pennsylvania 18360
UPMC Cancer Center-Uniontown
Uniontown, Pennsylvania 15401
Uniontown, Pennsylvania 15401
UPMC Uniontown Hospital Radiation Oncology
Uniontown, Pennsylvania 15401
Uniontown, Pennsylvania 15401
Contact:
Site Public Contact
724-437-2503
Site Public Contact
724-437-2503
UPMC Cancer Center-Washington
Washington, Pennsylvania 15301
Washington, Pennsylvania 15301
UPMC Washington Hospital Radiation Oncology
Washington, Pennsylvania 15301
Washington, Pennsylvania 15301
Chester County Hospital
West Chester, Pennsylvania 19380
West Chester, Pennsylvania 19380
Contact:
Site Public Contact
610-431-5297
Site Public Contact
610-431-5297
Reading Hospital
West Reading, Pennsylvania 19611
West Reading, Pennsylvania 19611
Contact:
Site Public Contact
610-988-9323
Site Public Contact
610-988-9323
Wexford Health and Wellness Pavilion
Wexford, Pennsylvania 15090
Wexford, Pennsylvania 15090
Geisinger Wyoming Valley/Henry Cancer Center
Wilkes-Barre, Pennsylvania 18711
Wilkes-Barre, Pennsylvania 18711
Divine Providence Hospital
Williamsport, Pennsylvania 17754
Williamsport, Pennsylvania 17754
WellSpan Health-York Cancer Center
York, Pennsylvania 17403
York, Pennsylvania 17403
Contact:
Site Public Contact
877-441-7957
Site Public Contact
877-441-7957
UPMC Memorial
York, Pennsylvania 17408
York, Pennsylvania 17408
Contact:
Site Public Contact
717-724-6760
Site Public Contact
717-724-6760
Rhode Island Hospital
Providence, Rhode Island 02903
Providence, Rhode Island 02903
Contact:
Site Public Contact
401-444-1488
Site Public Contact
401-444-1488
Smilow Cancer Hospital Care Center - Westerly
Westerly, Rhode Island 02891
Westerly, Rhode Island 02891
Saint Joseph's/Candler - Bluffton Campus
Bluffton, South Carolina 29910
Bluffton, South Carolina 29910
Medical University of South Carolina
Charleston, South Carolina 29425
Charleston, South Carolina 29425
Saint Francis Hospital
Greenville, South Carolina 29601
Greenville, South Carolina 29601
Saint Francis Cancer Center
Greenville, South Carolina 29607
Greenville, South Carolina 29607
Self Regional Healthcare
Greenwood, South Carolina 29646
Greenwood, South Carolina 29646
Gibbs Cancer Center-Pelham
Greer, South Carolina 29651
Greer, South Carolina 29651
Spartanburg Medical Center
Spartanburg, South Carolina 29303
Spartanburg, South Carolina 29303
Houston Methodist San Jacinto Hospital
Baytown, Texas 77521
Baytown, Texas 77521
Houston Methodist Hospital
Houston, Texas 77030
Houston, Texas 77030
Contact:
Site Public Contact
713-790-2700
Site Public Contact
713-790-2700
Methodist Willowbrook Hospital
Houston, Texas 77070
Houston, Texas 77070
Houston Methodist Saint John Hospital
Nassau Bay, Texas 77058
Nassau Bay, Texas 77058
University of Texas Health Science Center at San Antonio
San Antonio, Texas 78229
San Antonio, Texas 78229
Houston Methodist Sugar Land Hospital
Sugar Land, Texas 77479
Sugar Land, Texas 77479
Contact:
Site Public Contact
281-242-2873
Site Public Contact
281-242-2873
Houston Methodist The Woodlands Hospital
The Woodlands, Texas 77385
The Woodlands, Texas 77385
American Fork Hospital / Huntsman Intermountain Cancer Center
American Fork, Utah 84003
American Fork, Utah 84003
Farmington Health Center
Farmington, Utah 84025
Farmington, Utah 84025
Logan Regional Hospital
Logan, Utah 84321
Logan, Utah 84321
Intermountain Medical Center
Murray, Utah 84107
Murray, Utah 84107
McKay-Dee Hospital Center
Ogden, Utah 84403
Ogden, Utah 84403
Utah Valley Regional Medical Center
Provo, Utah 84604
Provo, Utah 84604
Riverton Hospital
Riverton, Utah 84065
Riverton, Utah 84065
Saint George Regional Medical Center
Saint George, Utah 84770
Saint George, Utah 84770
University of Utah Sugarhouse Health Center
Salt Lake City, Utah 84106
Salt Lake City, Utah 84106
Utah Cancer Specialists-Salt Lake City
Salt Lake City, Utah 84106
Salt Lake City, Utah 84106
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah 84112
Salt Lake City, Utah 84112
LDS Hospital
Salt Lake City, Utah 84143
Salt Lake City, Utah 84143
Central Vermont Medical Center/National Life Cancer Treatment
Berlin, Vermont 05602
Berlin, Vermont 05602
Contact:
Site Public Contact
802-225-5400
Site Public Contact
802-225-5400
University of Vermont Medical Center
Burlington, Vermont 05401
Burlington, Vermont 05401
Norris Cotton Cancer Center-North
Saint Johnsbury, Vermont 05819
Saint Johnsbury, Vermont 05819
Inova Alexandria Hospital
Alexandria, Virginia 22304
Alexandria, Virginia 22304
Inova Schar Cancer Institute
Fairfax, Virginia 22031
Fairfax, Virginia 22031
Inova Fair Oaks Hospital
Fairfax, Virginia 22033
Fairfax, Virginia 22033
Bon Secours Saint Francis Medical Center
Midlothian, Virginia 23114
Midlothian, Virginia 23114
Bon Secours Cancer Institute at Reynolds Crossing
Richmond, Virginia 23230
Richmond, Virginia 23230
Virginia Commonwealth University/Massey Cancer Center
Richmond, Virginia 23298
Richmond, Virginia 23298
Oncology and Hematology Associates of Southwest Virginia
Roanoke, Virginia 24014
Roanoke, Virginia 24014
Virginia Mason Medical Center
Seattle, Washington 98101
Seattle, Washington 98101
Legacy Cancer Institute Medical Oncology and Day Treatment
Vancouver, Washington 98684
Vancouver, Washington 98684
Legacy Salmon Creek Hospital
Vancouver, Washington 98686
Vancouver, Washington 98686
Contact:
Site Public Contact
503-413-2150
Site Public Contact
503-413-2150
Wheeling Hospital/Schiffler Cancer Center
Wheeling, West Virginia 26003
Wheeling, West Virginia 26003
Contact:
Site Public Contact
304-243-6442
Site Public Contact
304-243-6442
Langlade Hospital and Cancer Center
Antigo, Wisconsin 54409
Antigo, Wisconsin 54409
ThedaCare Regional Cancer Center
Appleton, Wisconsin 54911
Appleton, Wisconsin 54911
Ascension Saint Elizabeth Hospital
Appleton, Wisconsin 54915
Appleton, Wisconsin 54915
Northwest Wisconsin Cancer Center
Ashland, Wisconsin 54806
Ashland, Wisconsin 54806
Ascension Southeast Wisconsin Hospital - Elmbrook Campus
Brookfield, Wisconsin 53045
Brookfield, Wisconsin 53045
Aurora Cancer Care-Southern Lakes VLCC
Burlington, Wisconsin 53105
Burlington, Wisconsin 53105
Ascension Calumet Hospital
Chilton, Wisconsin 53014
Chilton, Wisconsin 53014
HSHS Sacred Heart Hospital
Eau Claire, Wisconsin 54701
Eau Claire, Wisconsin 54701
Ascension Saint Francis - Reiman Cancer Center
Franklin, Wisconsin 53132
Franklin, Wisconsin 53132
Aurora Health Care Germantown Health Center
Germantown, Wisconsin 53022
Germantown, Wisconsin 53022
Aurora Cancer Care-Grafton
Grafton, Wisconsin 53024
Grafton, Wisconsin 53024
Saint Vincent Hospital Cancer Center Green Bay
Green Bay, Wisconsin 54301
Green Bay, Wisconsin 54301
Saint Vincent Hospital Cancer Center at Saint Mary's
Green Bay, Wisconsin 54303
Green Bay, Wisconsin 54303
Aurora BayCare Medical Center
Green Bay, Wisconsin 54311
Green Bay, Wisconsin 54311
Aurora Cancer Care-Kenosha South
Kenosha, Wisconsin 53142
Kenosha, Wisconsin 53142
Mayo Clinic Health System-Franciscan Healthcare
La Crosse, Wisconsin 54601
La Crosse, Wisconsin 54601
Contact:
Site Public Contact
855-776-0015
Site Public Contact
855-776-0015
Aurora Bay Area Medical Group-Marinette
Marinette, Wisconsin 54143
Marinette, Wisconsin 54143
Froedtert Menomonee Falls Hospital
Menomonee Falls, Wisconsin 53051
Menomonee Falls, Wisconsin 53051
Contact:
Site Public Contact
262-257-5100
Site Public Contact
262-257-5100
Ascension Columbia Saint Mary's Hospital Ozaukee
Mequon, Wisconsin 53097
Mequon, Wisconsin 53097
Aurora Cancer Care-Milwaukee
Milwaukee, Wisconsin 53209
Milwaukee, Wisconsin 53209
Ascension Columbia Saint Mary's Hospital - Milwaukee
Milwaukee, Wisconsin 53211
Milwaukee, Wisconsin 53211
Aurora Saint Luke's Medical Center
Milwaukee, Wisconsin 53215
Milwaukee, Wisconsin 53215
Medical College of Wisconsin
Milwaukee, Wisconsin 53226
Milwaukee, Wisconsin 53226
Contact:
Site Public Contact
414-805-3666
Site Public Contact
414-805-3666
Aurora Sinai Medical Center
Milwaukee, Wisconsin 53233
Milwaukee, Wisconsin 53233
Zablocki Veterans Administration Medical Center
Milwaukee, Wisconsin 53295
Milwaukee, Wisconsin 53295
Contact:
Site Public Contact
888-469-6614
Site Public Contact
888-469-6614
Drexel Town Square Health Center
Oak Creek, Wisconsin 53154
Oak Creek, Wisconsin 53154
Contact:
Site Public Contact
414-805-0505
Site Public Contact
414-805-0505
Ascension Mercy Hospital
Oshkosh, Wisconsin 54904
Oshkosh, Wisconsin 54904
Vince Lombardi Cancer Clinic - Oshkosh
Oshkosh, Wisconsin 54904
Oshkosh, Wisconsin 54904
Ascension All Saints Hospital
Racine, Wisconsin 53405
Racine, Wisconsin 53405
Aurora Cancer Care-Racine
Racine, Wisconsin 53406
Racine, Wisconsin 53406
Ascension Saint Mary's Hospital
Rhinelander, Wisconsin 54501
Rhinelander, Wisconsin 54501
Saint Vincent Hospital Cancer Center at Sheboygan
Sheboygan, Wisconsin 53081
Sheboygan, Wisconsin 53081
Vince Lombardi Cancer Clinic-Sheboygan
Sheboygan, Wisconsin 53081
Sheboygan, Wisconsin 53081
Ascension Saint Michael's Hospital
Stevens Point, Wisconsin 54481
Stevens Point, Wisconsin 54481
Saint Vincent Hospital Cancer Center at Sturgeon Bay
Sturgeon Bay, Wisconsin 54235-1495
Sturgeon Bay, Wisconsin 54235-1495
Aurora Medical Center in Summit
Summit, Wisconsin 53066
Summit, Wisconsin 53066
Vince Lombardi Cancer Clinic-Two Rivers
Two Rivers, Wisconsin 54241
Two Rivers, Wisconsin 54241
Aspirus Regional Cancer Center
Wausau, Wisconsin 54401
Wausau, Wisconsin 54401
Contact:
Site Public Contact
877-405-6866
Site Public Contact
877-405-6866
Ascension Medical Group Southeast Wisconsin - Mayfair Road
Wauwatosa, Wisconsin 53226
Wauwatosa, Wisconsin 53226
Aurora Cancer Care-Milwaukee West
Wauwatosa, Wisconsin 53226
Wauwatosa, Wisconsin 53226
Aurora West Allis Medical Center
West Allis, Wisconsin 53227
West Allis, Wisconsin 53227
Froedtert West Bend Hospital/Kraemer Cancer Center
West Bend, Wisconsin 53095
West Bend, Wisconsin 53095
Contact:
Site Public Contact
414-805-0505
Site Public Contact
414-805-0505
Aspirus Cancer Care - Wisconsin Rapids
Wisconsin Rapids, Wisconsin 54494
Wisconsin Rapids, Wisconsin 54494
Contact:
Site Public Contact
715-422-7718
Site Public Contact
715-422-7718
More Details
- NCT ID
- NCT04513717
- Status
- Recruiting
- Sponsor
- NRG Oncology
Detailed Description
PRIMARY OBJECTIVES: I. To determine whether men with National Comprehensive Cancer Network (NCCN) high risk prostate cancer who are in the lower 2/3 of Decipher genomic risk (=< 0.85) can be treated with 12 months androgen deprivation therapy (ADT) plus radiation therapy (RT) instead of 24 months ADT+RT and experience non-inferior metastasis-free survival. (De-intensification study) II. To determine whether men with NCCN high risk prostate cancer who are in the upper 1/3 of Decipher genomic risk (> 0.85) or have node-positive disease by conventional imaging (magnetic resonance imaging [MRI] or computed tomography [CT] scan) will have a superior metastasis-free survival (MFS) through treatment intensification with apalutamide added to the standard of RT plus 24 month ADT. (Intensification study) SECONDARY OBJECTIVES: I. To compare overall survival (OS) between the standard of care (RT plus 24 months of ADT) and either the de-intensification (RT plus 12 months of ADT) or intensification arm (RT plus 24 months of ADT plus apalutamide). (De-intensification and intensification studies) II. To compare time to prostate specific antigen (PSA) failure or start of salvage treatment between the standard of care (RT plus 24 months of ADT) and either the de-intensification arm (RT plus 12 months of ADT) or intensification arm (RT plus 24 months of ADT plus apalutamide). (De-intensification and intensification studies) III. To compare PSA failure-free survival with non-castrate testosterone and no additional therapies between the standard of care (RT plus 24 months of ADT) and either the de-intensification arm (RT plus 12 months of ADT) or intensification arm (RT plus 24 months of ADT plus apalutamide). (De-intensification and intensification studies) IV. To compare MFS judged based on either standard or molecular imaging between the standard of care (RT plus 24 months of ADT) and either the de-intensification arm (RT plus 12 months of ADT) or intensification arm (RT plus 24 months of ADT plus apalutamide). (De-intensification and intensification studies) V. To compare prostate cancer-specific mortality between the standard of care (RT plus 24 months of ADT) and either the de-intensification arm (RT plus 12 months of ADT) or intensification arm (RT plus 24 months of ADT plus apalutamide). (De-intensification and intensification studies) VI. To compare testosterone levels at the time of PSA failure and metastases between the standard of care (RT plus 24 months of ADT) and either the de-intensification arm (RT plus 12 months of ADT) or intensification arm (RT plus 24 months of ADT plus apalutamide). (De-intensification and intensification studies) VII. To compare time to testosterone recovery (defined as a T > 200) between the standard of care (RT plus 24 months of ADT) and either the de-intensification arm (RT plus 12 months of ADT) or intensification arm (RT plus 24 months of ADT plus apalutamide). (De-intensification and intensification studies) VIII. To compare adverse events, both clinician-reported using Common Terminology Criteria for Adverse Events (CTCAE) version (v) 5.0 and patient-reported using Patient Reported Outcome (PRO)-CTCAE items, between the standard of care (RT plus 24 months of ADT) and either the de-intensification arm (RT plus 12 months of ADT) or intensification arm (RT plus 24 months of ADT plus apalutamide). (De-intensification and intensification studies) EXPLORATORY OBJECTIVES: I. To compare changes in cardio-metabolic markers, including body mass index, and waist circumference, between the standard of care (RT plus 24 months of ADT) and either the de-intensification arm (RT plus 12 months of ADT) or intensification arm (RT plus 24 months of ADT plus apalutamide). (De-intensification and intensification studies) II. To determine a machine learning/artificial intelligence algorithm for radiotherapy quality assurance. (De-intensification and Intensification studies) III. To perform future translational correlative studies using biological and imaging data. (De-intensification and intensification studies) IV. Impact of PET use in high-risk prostate cancer PATIENT-REPORTED OUTCOMES OBJECTIVES: PRIMARY OBJECTIVES: I. To compare sexual and hormonal function related quality of life, as measured by the Expanded Prostate Cancer Index Composite-26 (EPIC), between the standard of care (RT plus 24 months of ADT) and the de-intensification arm (RT plus 12 months of ADT). (De-Intensification Study) II. To compare fatigue, as measured by the Patient Reported Outcomes Measurement Information System (PROMIS)-Fatigue instrument, between the standard of care (RT plus 24 months of ADT) and the intensification arm (RT plus 24 months of ADT plus apalutamide). (Intensification Study) SECONDARY OBJECTIVES: I. To compare depression, as measured by the PROMIS-depression, between the standard of care (RT plus 24 months of ADT) and the de-intensification arm (RT plus 12 months of ADT). (De-Intensification Study) II. To compare depression, as measured by the PROMIS-depression, between the standard of care (RT plus 24 months of ADT) and the intensification arm (RT plus 24 months of ADT plus apalutamide). (Intensification Study) EXPLORATORY OBJECTIVES: I. To compare cognition, as measured by the Functional Assessment of Chronic Illness Therapy-Cognitive (FACT-Cog) perceived cognitive abilities subscale, between the standard of care (RT plus 24 months of ADT) and the de-intensification arm (RT plus 12 months of ADT). (De-Intensification Study) II. To compare bowel and urinary function related quality of life, as measured by the Expanded Prostate Cancer Index Composite-26 (EPIC), between the standard of care (RT plus 24 months of ADT) and the de-intensification arm (RT plus 12 months of ADT). (De-Intensification Study) III. To compare fatigue, as measured by the PROMIS-Fatigue instrument, between the standard of care (RT plus 24 months of ADT) and the de-intensification arm (RT plus 12 months of ADT). (De-Intensification Study) IV. To compare sexual and hormonal function related quality of life, as measured by the Expanded Prostate Cancer Index Composite-26 (EPIC), between the standard of care (RT plus 24 months of ADT) and the intensification arm (RT plus 24 months of ADT plus apalutamide). (Intensification Study) V. To compare bowel and urinary function related quality of life, as measured by the Expanded Prostate Cancer Index Composite-26 (EPIC), between the standard of care (RT plus 24 months of ADT) and the intensification arm (RT plus 24 months of ADT plus apalutamide). (Intensification Study) VI. To compare cognition, as measured by the Functional Assessment of Chronic Illness Therapy-Cognitive (FACT-Cog) perceived cognitive abilities subscale, between the standard of care (RT plus 24 months of ADT) and the intensification arm (RT plus 24 months of ADT plus apalutamide). (Intensification Study) OUTLINE: Patients are randomized to 1 of 4 arms. DE-INTENSIFICATION STUDY (DECIPHER SCORE =< 0.85): ARM I: Patients undergo radiation therapy (RT) over 2-11 weeks and receive ADT (consisting of either leuprolide, goserelin, triptorelin, degarelix, buserelin or histrelin and bicalutamide or flutamide) for 24 months in the absence of disease progression or unacceptable toxicity. ARM II: Patients undergo RT over 2-11 weeks and receive ADT (consisting of either leuprolide, goserelin, triptorelin, degarelix, buserelin or histrelin and bicalutamide or flutamide) for 12 months in the absence of disease progression or unacceptable toxicity. INTENSIFICATION STUDY (DECIPHER SCORE > 0.85 OR NODE POSITIVE): ARM III: Patients undergo RT over 2-11 weeks and receive ADT (consisting of either leuprolide, goserelin, triptorelin, degarelix, buserelin or histrelin and bicalutamide or flutamide) for 24 months in the absence of disease progression or unacceptable toxicity. ARM IV: Patients undergo RT over 2-11 weeks and receive ADT (consisting of either leuprolide, goserelin, triptorelin, degarelix, buserelin or histrelin) for 24 months in the absence of disease progression or unacceptable toxicity. Patients also receive apalutamide orally (PO) once daily (QD). Treatment repeats every 90 days for up to 8 cycles (24 months) in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up annually.