Dose-Escalated MR-Guided Radiotherapy for Localized Prostate Cancer (NCT07674225) | Clinical Trial Compass
Active — Not RecruitingNot Applicable
Dose-Escalated MR-Guided Radiotherapy for Localized Prostate Cancer
Canada24 participantsStarted 2026-03-22
Plain-language summary
DESTINATION 2 is a multi-centre randomised trial treating intermediate risk localised prostate cancer with 2 fraction Stereotactic Body Radiotherapy (SBRT). All radiotherapy will be delivered in two fractions (sessions) on an MR Linac using daily adaptation. Men will either receive uniform dose radiotherapy or de-escalated dose radiotherapy. The primary endpoint is acute GU CTCAE v5 grade 2+ toxicity. It will also look at late toxicity, patient-reported outcome measures and PSA control.
Who can participate
Age range
18 Years
Sex
MALE
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion criteria
. Men aged ≥18 years
. Histological confirmation of prostate adenocarcinoma requiring radical radiotherapy
. Gleason score 3+3, 3+4 or 4+3 (Grade groups (GG) 1, 2 or 3)
. MRI stage T3a or less (as staged by AJCC TNM 2018). MRI must be performed within a year of randomisation
. MRI-visible tumour(s) of PIRADS v2 grade 3 or higher and able to be delineated on T2 and diffusion-weighted imaging +/- dynamic contrast-enhanced imaging. Tumour nodule visible on MRI should be considered able to be boosted by treating clinician and \<2.5cm in maximal dimension
. The MRI-defined lesion must be confirmed as malignant on biopsies (Gleason grade must be within the limits expressed in inclusion factor 3)
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
. Short course (\< 6 months) concurrent androgen deprivation therapy (antiandrogens or LHRH analogues) allowed though not mandated as per the discretion of the treating physician.
. PSA \<20 ng/ml prior to starting ADT, if used
Exclusion criteria
. Contraindications to MRI (e.g. pacemaker, potentially mobile metal implant, claustrophobia)
. IPSS Score \> 19
. High grade disease (GG3) occult to MRI-defined lesion.
. Prostate volume \>90cc
. Comorbidities which predispose to significant toxicity (e.g. inflammatory bowel disease) or preclude long term follow up
. Hip replacement, or other pelvic metalwork which causes significant artefact on diffusion-weighted imaging
. Previous pelvic radiotherapy
. Patients needing \>6 months of ADT due to disease parameters, as per the discretion of the treating physician