Circulating Tumor DNA in High Risk Localized Prostate Cancer

Inclusion criteria

• Must have histologically confirmed prostate cancer.
• Age ≥ 18 years.
• ECOG performance status of 0-1.
• Must have the ability to understand and the willingness to sign a written informed consent document.
• Willing to provide serial blood samples for the study.
• Willing to provide tumor tissue (prostatectomy for primary cohort; prostatectomy or biopsy for exploratory cohort) for correlative studies which will compare ctDNA to tumor specimens.
• Primary Cohort: High-risk localized prostate adenocarcinoma defined as one or more of the following:
• Clinical stage ≥ cT3a, Grade Group 4 or 5 (Gleason sum 8-10), and PSA ≥ 20
• \*Non-bulky pelvic lymphadenopathy and indeterminate findings on staging imaging (CT, bone scan, PSMA PET CT) are allowed if the surgeon believes RP is appropriate.
• Exploratory Cohort: Men with a diagnosis of prostate adenocarcinoma and one of the following:
• Localized prostate adenocarcinoma on active surveillance
• Biochemically-recurrent prostate adenocarcinoma after definitive local therapy
• Hormone-sensitive, metastatic prostate adenocarcinoma
• Metastatic CRPC

Exclusion criteria

• History of another primary cancer within the last 3 years, except for non-melanomatous skin cancer.
• Receiving androgen deprivation or other systemic therapy for prostate cancer.
• Medical condition or social situation that may preclude adherence to the protocol.