A Study of Lower Dose Radiation Therapy for People With Prostate Cancer

June 4, 2026 updated by: Memorial Sloan Kettering Cancer Center

Dose dE-eScalaTion IN prostATe radIOtherapy usiNg an MR-Linac in 2 Fractions - A Randomized Trial (DESTINATION 2)

The purpose of this study is to see whether giving a lower (de-escalated) dose of radiation therapy to some parts of the prostate can reduce side effects compared to giving the same (uniform) dose of radiation therapy to the whole prostate.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

54

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Zachary Moore, MD, PhD
  • Phone Number: 212-639-5803
  • Email: MooreZ@mskcc.org

Study Locations

  • United States
    • New Jersey
      • Basking Ridge, New Jersey, United States, 07920
        • Recruiting
        • Memorial Sloan Kettering at Basking Ridge (Limited Protocol Activities)
        • Contact:
      • Middletown, New Jersey, United States, 07748
        • Recruiting
        • Memorial Sloan Kettering at Monmouth (Limited Protocol Activities)
        • Contact:
      • Montvale, New Jersey, United States, 07645
        • Recruiting
        • Memorial Sloan Kettering at Bergen (Limited Protocol Activities)
        • Contact:
    • New York
      • Commack, New York, United States, 11725
        • Recruiting
        • Memorial Sloan Kettering at Suffolk-Commack (Limited Protocol Activities)
        • Contact:
      • Harrison, New York, United States, 10604
        • Recruiting
        • Memorial Sloan Kettering at Westchester (Limited Protocol Activities)
        • Contact:
      • New York, New York, United States, 10065
        • Recruiting
        • Memorial Sloan Kettering Cancer Center (All Protocol Activities)
        • Contact:
          • Victoria Brennan, MBBCH BAO
          • Phone Number: 212-639-8904
      • Uniondale, New York, United States, 11553
        • Recruiting
        • Memorial Sloan Kettering at Nassau (Limited Protocol Activities)
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Documentation of Disease

    o Patients must have pathologically confirmed prostate adenocarcinoma.

  • Definition of Disease

    • Grade Group (GG) 1, 2, or 3.
    • PSA less than 20 ng/mL prior to starting ADT, if used.
    • Clinical stage of TX, T1 or T2 on digital rectal examination. May have up to radiological stage T3a on MRI. MRI must be performed within 12 months of randomization.
    • MRI-visible tumor(s), all having PIRADS v2 scores of 3, 4, or 5. Each tumor should be able to be delineated on T2 and diffusion-weighted imaging (DWI) +/- dynamic contrast-enhanced imaging (DCE).
    • Tumor nodule visible on MRI should be considered able to be boosted by treating clinician (ie meet urethral constraints while maintaining mandatory GTV coverage) and <2.5cm in maximal dimension.
    • The MRI-defined lesion must be confirmed as malignant on biopsies (Grade group 1, 2, or 3).
    • Patients can be concurrently treated with androgen deprivation therapy (ADT) if this would be standard of care. LHRH analogues, LHRH agonists or Bicalutamide are permitted. ADT is not mandatory where this would usually be omitted. Patients needing greater than 6 months of ADT due to disease parameters should be excluded.
    • No high grade disease (GG3) occult to MRI-defined lesion. As a guide, any pathology for which you would consider surveillance (e.g. GG1, low volume GG2) is allowed outside of the MRI-defined area.
    • No contraindications to MRI (e.g. pacemaker, potentially mobile metal implant, claustrophobia).
    • Prostate volume less than or equal to 90mL.
    • No evidence of nodal or distant metastatic disease.

  • Prior Treatment

    o No history of previous radiation to the prostate, prostate surgery (including transurethral resection of the prostate (TURP)), or other local prostate cancer treatments.

  • Age ≥ 18
  • ECOG Performance Status of ≤ 2 (See Appendix I for performance status criteria)

  • Required Organ Function

    • Adequate hematologic function defined as follows:

      • Absolute neutrophil count (ANC) ≥ 1,500 cells/mm3
      • Platelets ≥ 100,000 cells/mm3
      • Hemoglobin ≥ 8 g/dl

    • Adequate renal function defined as follows:

      • Creatinine clearance (CrCL) of ≥30 mL/min by the Cockcroft-Gault formula:

CrCl (mL/min) = [140 - age (years)] x weight (kg) / 72 x creatinine (mg / dL) {x 0.85 for female patients}

  • Adequate hepatic function defined as follows:

    • Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) (patients with known Gilbert's disease who have bilirubin level ≤ 3 x ULN may be enrolled)
    • AST and ALT ≤3 x institutional ULN

  • Adequate cardiac function defined as follows:

    • 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.

    • To be eligible for this trial, patients should be class 2B or better (see Appendix II: New York Heart Association (NYHA) Functional Classification).

      • Comorbid Conditions
  • No active infection requiring parenteral antibiotic(s).
  • 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.
  • No severe GU symptoms that would preclude extreme hypofractionation per the discretion of the treating physician.
  • No IPSS Score greater than 19.

  • No comorbidities which predispose to significant toxicity (e.g. inflammatory bowel disease) or preclude long term follow up.

    • Ability of the participant to understand and the willingness to sign a written informed consent form.
    • Willing to consent to contraception during and for 1 year after treatment when applicable.
    • Ability/willingness to comply with the patient reported outcome questionnaires schedule throughout the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Group 1: Uniform dose SBRT
Radiation: MR-guided Stereotactic Body Radiation Therapy
MR-guided 2 fraction Stereotactic Body Radiation Therapy
Other Names:
  • MR-guided SBRT
Experimental: Group 2: De-escalated dose SBRT
Radiation: MR-guided Stereotactic Body Radiation Therapy
MR-guided 2 fraction Stereotactic Body Radiation Therapy
Other Names:
  • MR-guided SBRT

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of participants with acute GU toxicities
Time Frame: 12 weeks from the start of radiation therapy
To estimate the absolute and relative risk of acute GU toxicity (CTCAE v5) when delivering dose de-escalated or uniform dose prostate SBRT, both using a 2-fraction regimen.
12 weeks from the start of radiation therapy

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Memorial Sloan Kettering Cancer Center

Investigators

  • Principal Investigator: Victoria Brennan, MBBCH BAO, Memorial Sloan Kettering Cancer Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 28, 2026

Primary Completion (Estimated)

May 28, 2030

Study Completion (Estimated)

May 28, 2030

Study Registration Dates

First Submitted

May 29, 2026

First Submitted That Met QC Criteria

June 4, 2026

First Posted (Actual)

June 9, 2026

Study Record Updates

Last Update Posted (Actual)

June 9, 2026

Last Update Submitted That Met QC Criteria

June 4, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 26-150

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Memorial Sloan Kettering Cancer Center supports the international committee of medical journal editors (ICMJE) and the ethical obligation of responsible sharing of data from clinical trials. The protocol summary, a statistical summary, and informed consent form will be made available on clinicaltrials.gov when required as a condition of Federal awards, other agreements supporting the research and/or as otherwise required. Requests for deidentified individual participant data can be made following one year after publication and for up to 36 months later. Deidentified individual participant data reported in the manuscript will be shared under the terms of a Data Use Agreement and may only be used for approved proposals. Requests may be made to: crdatashare@mskcc.org.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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