Can targeted radiation boost prostate cancer control?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Subjects must have biopsy-confirmed adenocarcinoma of the prostate * Subjects must discontinue any prior systemic therapies (excluding GnRH agonist/antagonists) without PSA withdrawal effects if using first generation anti-androgens. Luteinizing hormone-releasing hormone (LHRH) analogues must be continued if they have not undergone orchiectomy. (Subjects who recently started systemic therapy for metastatic castration-resistant prostate cancer (mCRPC) are eligible to enroll if new therapy was started ≤ 14 days to consent date.) * Subjects must have progressive metastatic castration-resistant prostate cancer based on at least one of the following criteria while having castrate levels (\<50 ng/dL) of testosterone: * A) PSA progression defined as a 25% increase over baseline value with an increase in the absolute value of at least 2.0 ng/mL that is confirmed by another PSA level with a minimum of a 1-week interval. * B) Progression of bidimensionally measurable soft tissue or nodal metastasis by CT scan or MRI based on RECIST criteria * C) Progression of bone disease on bone scan as defined by two new lesions arising * Subjects must have oligometastatic prostate cancer, defined as between 1 and ≤5 treatment sites that can be treated within a radiotherapy treatment field. * Subjects must be medically fit to undergo radiotherapy and systemic therapy as determined by the treating physician. * Age ≥ 18 * ECOG ≤ 2 (Eastern Cooperative Oncology Group scoring system used to quantify general well-being and activities of daily life; scores range from 0 to 5 where 0 represents perfect health and 5 represents death) * No prior invasive malignancy in the past 3-years. Exceptions include non-melanomatous skin cancer and in situ cancers of the bladder or head and neck are permissible. * Subjects must freely sign informed consent to enroll in the study. * Subjects must use contraception up to 90 days after last drug dose. Exclusion Criteria: * Planned systemic therapy with Radium-223 dichloride or sipuleucel-T * Tumor requiring emergent radiation in view of provider * Life expectancy estimate of \<3 months * Presence of known parenchymal brain metastasis * Uncontrolled intercurrent illness * Inability to undergo radiotherapy, systemic treatment, CTs or bone scans * Biopsy proven pure small cell or neuroendocrine prostate cancer