TERPS Trial for de Novo Oligometastic Prostate Cancer

Inclusion Criteria:

Patient must have at least one and up to three asymptomatic metastatic tumor(s) of the bone or soft tissue (with at least one bone metastasis) develop within the past 6-months that are seen on imaging. Up to five lesions are allowed on advanced functional imaging such as fluciclovine (Axumin), choline or PSMA PET-CT scan.

CT or MRI scan within 6 months of enrollment
Bone scan within 6 months of enrollment
Fluciclovine (Axumin), choline, or PSMA PET-CT scan within 6 months of enrollment (PET-CT scan is reasonable for study entry imaging as an alternative to CT/MRI scan and bone scan)
Histologic confirmation of malignancy (primary or metastatic tumor).
Patient may have had prior systemic therapy and/or ADT associated with treatment within 9-months of enrollment.
PSA > 0.5 but <100.
Patient must be ≥ 18 years of age.
Patient must have a life expectancy ≥ 12 months.
Patient must have an ECOG performance status ≤ 2.
Patient must have the ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

Castration-resistant prostate cancer (CRPC).
Prior radiation therapy to an overlapping site of a target lesion that would preclude further radiation therapy
Spinal cord compression or impending spinal cord compression.
Suspected pulmonary and/or liver metastases (greater >10 mm in largest axis).
Patient receiving any other investigational agents.
Inability to receive any form of systemic therapy in the opinion of a treating medical oncologist .
Unable to lie flat during or tolerate PET/MRI, PET/CT or SABR.
No radiographical evidence of cranial metastasis.
Refusal to sign informed consent.