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RecruitingNCT06582446HypoElectUpdated Sep 17, 2026

Artificial Intelligence to Personalize Prostate Cancer Treatment (the HypoElect Trial)

A Phase 2 interventional study of Androgen Deprivation Therapy (ADT) - Goserelin and High-Dose-Rate Interstitial Brachytherapy (HDR BRT) in Prostate Cancer, sponsored by German Oncology Center, Cyprus. Recruiting at 1 site in Cyprus. Open to male participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-17.

Sponsored by German Oncology Center, Cyprus · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Sep 2024; still recruiting 2 years 1 month later.
Phase
Phase 2
Study type
Interventional
Enrollment
30
Allocation
Not applicable
Ages
18 Years and older
Sex
Male
01

Study summary

A prospective, single-arm phase II study is the individualization of RT for patients with high-risk localized PCa based on multimodal artificial intelligence (MMAI). All patients will receive the current standard of care: (i) a dose escalation to the prostate via HDR brachytherapy, (ii) two years of ADT and (iii) whole-pelvis UHF-RT (5 fractions).

Read the detailed description

Prostate cancer (PCa) is the most frequent diagnosed malignancy in male patients in Europe and radiation therapy (RT) is a main treatment option. For primary high-risk localized PCa patients, NCCNv4.2023 guidelines recommend normo- or hypofractionated RT to the prostate ± the elective pelvic lymphatics and systemic treatment in terms of ADT. Although the standard of care, the benefit of this therapy regimen is controversially discussed: the benefit of (i) an RT dose escalation using brachytherapy (2) or focal dose escalated RT(3) or (ii) an elective RT of the pelvic lymph nodes (1) is not finally proven yet. In parallel, first studies proposed a reduction in treatment fractions in terms of ultra-hypofractionated RT (UHF-RT) (4).

The aim of this prospective, single-arm phase II study is the individualization of RT for patients with high-risk localized PCa based on MMAI. All patients will receive the current standard of care: (i) a dose escalation to the prostate via HDR brachytherapy, (ii) two years of ADT and (iii) whole-pelvis UHF-RT (5 fractions).

For the HypoElect patients we expect no significant differences in toxicity rates compared to the randomized controlled POP-RT trial (1) which treated the patients with moderately-hypofractionated RT to the prostate and the elective pelvic lymph nodes in parallel to 24 months of ADT. Secondary endpoints like relapse free survival, metastatic free survival, prostate cancer survival and overall survival will depict the oncologic efficacy in this patient cohort. Thus, the safety and oncologic outcome results of this study might be the first in this highly selected treatment group: NCCN high-risk, PSMA PET cN0/cM0 and MMAI high-risk. Considering the epidemiological importance of the PCa these results could have a significant socio-economic impact. In parallel a translational research program will address the identification of novel biomarkers to predict the treatment outcome.

02

Conditions studied

  • Prostate Cancer

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Keywords

  • prostate cancer
  • multimodal AI
  • radiotherapy
  • phase II
03

In context

Prostatic Neoplasms

7,046 studies on the registry are indexed under Prostatic Neoplasms; 1,580 are open to participants now.

This study's planned enrollment of 30 is below the median of 60 across 5,348 interventional studies indexed under Prostatic Neoplasms.

Browse Prostatic Neoplasms studies →

Lead sponsor

German Oncology Center, Cyprus is the lead sponsor of 4 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Male
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • confirmed adenocarcinoma of the prostate (histological confirmation can be based on tissue taken at any time, but a re- should be considered if the biopsy is more than 12 months old)
  • Primary PCa (in PSMA-PET imaging and multiparametric magnetic resonance imaging (mpMRI)
  • High- or very high-risk according to NCCNv1.2023 criteria
  • Signed written for this study
  • Age >18 years
  • Previously conducted PSMA-PET/CT, mpMRI or PSMA-PET/MR
  • MMAI high-risk
  • Performance score 0 or 1
  • IPSS Score ≤15

Exclusion criteria

Exclusion Criteria:

  • Prior radiotherapy to the prostate or pelvis
  • Prior radical prostatectomy
  • Prior focal therapy approaches to the prostate
  • Evidence of pelvic nodal disease (cN+) in mpMRI and/or PSMA-PET/CT
  • Evidence of distant disease (cM+) in mpMRI and/or PSMA-PET/CT
  • Time gap between the beginning of any systemic therapyADT and conduction of PSMA-PET scans is >2 months
  • Evidence of cT4 disease in mpMRI and/or PSMA-PET/CT
  • PSA >50 ng/ml prior to starting of systemic therapy
  • Expected patient survival \<5 years
  • Bilateral hip prostheses or any other implants/hardware that would introduce substantial CT artifacts
  • to undergo a MRI scan
  • Contraindication to undergo HDR brachytherapy (brachytherapy not feasible due to large prostate volume, prostate anatomy, tumor in distant seminal vesicles and/or unfit for anesthesia)
  • Prostate surgery (TURP or HOLEP) with a significant tissue cavity or prostate surgery (TURP or HOLEP) within the last 6 months prior to randomization
  • Medical conditions likely to make radiotherapy inadvisable e.g. acute inflammatory bowel disease, hemiplegia or paraplegia
  • Previous within the last 2 years (except basal cell carcinoma or squamous cell carcinoma of the skin), or if previous malignancy is expected to significantly compromise 5 year survival
  • Any other contraindication to external beam radiotherapy (EBRT) to the pelvis
  • Participation in any other interventional clinical trial within the last 30 days before the start of this trial
  • Simultaneous participation in other interventional trials which could interfere with this trial; simultaneous participation in registry and diagnostic trials is allowed
  • Patient without legal capacity who is unable to understand the nature, significance and consequences of the trial
  • Known or persistent abuse of medication, drugs or alcohol
Terms in these criteria, in plain language(7)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
30 participants (estimated)

Study arms

  • Experimental
    Single experimental arm

    RT prostate (HDR brachytherapy): 15 Gy (D90) in 1 fraction HDR RT prostate EBRT elective pelvis (Ultra-hypofractionated RT - UHF): 25 Gy in 5 Gy per fraction Technique: IMRT/IGRT/HDR brachytherapy Duration: 6 fractions, 3 weeks Androgen deprivation therapy (ADT) - Goserelin: all patients receive ADT; luteinising-hormone-releasing hormone agonists or antagonists for 24 months Follow-up (FU) per patient: minimum FU time is 5 years (60 months), the study ends when the last enrolled patients reaches 60 months of FU time Further FU: by the end of this clinical trial it will be decided whether further FU is necessary, amendment to this clinical trial protocol will be done in appropriate time

    Drug: Androgen Deprivation Therapy (ADT) - Goserelin · Radiation: High-Dose-Rate Interstitial Brachytherapy (HDR BRT) · Radiation: radiotherapy

Interventions

  • DrugAndrogen Deprivation Therapy (ADT) - Goserelin

    The patients under ADT and the patients who will receive the ADT during the study will be included in the trial. * ADT will be applied for 24 months in total * ADT must be given concurrently and adjuvant

  • RadiationHigh-Dose-Rate Interstitial Brachytherapy (HDR BRT)

    HDR BRT Procedure will be performed using transperineal catheter implantation under transrectal US-guidance performed under anesthesia, spinal or general with patient in high lithotomy position.)

  • Radiationradiotherapy

    EBRT prostate + elective pelvis (Ultra-hypofractionated): 25 Gy in 5 Gy per fraction

06

What researchers measure

Primary outcomes

  1. cumulative GU toxicity

    Primary endpoint is cumulative GU toxicity according to RTOG grading after minimum FU time of two years.

    Time frame: two years

Secondary outcomes

  1. Time to local or regional failure

    Time to local or regional failure; after end of RT. Local or regional recurrences have to be confirmed by PSMA-PET or mpMR imaging. For the diagnosis of local failure a verification via biopsy is warranted.

    Time frame: two and five years after RT

  2. MMAI classifier

    Prognostic influence of MMAI classifier for outcome; the ArteraAI Prostate Test score (ranging from 0.0 to 1.0)

    Time frame: 5-year and 10-year risk prediction of distant metastasis and 10-year risk of prostate-specific mortality.

  3. Testosterone

    Testosterone recovery is to be done through blood test

    Time frame: assessment at 6,9,12,18 and 24 months after randomization (± 14 days for each visit) and at 30, 36, 42, 48, 54, 60 months after Ultra-hypofractionated RT - UHF (± 1 month

  4. Metastatic free survival (MFS)

    MFS after end of RT, (all metastases have to be confirmed by PSMA-PET/CT or mpMR imaging)

    Time frame: two and five years after RT

  5. Overall Survival (OS)

    OS after end of RT

    Time frame: 1, 3, 6, 9, 12, 18, 24, 30, 36, 42, 48, 54 and 60 months after RT

  6. Prostate cancer specific survival (PCSS)

    PCSS after end of RT

    Time frame: 1, 3, 6, 9, 12, 18, 24, 30, 36, 42, 48, 54 and 60 months after RT

  7. Biochemical failure

    Time to biochemical failure after end of RT (phoenix definition)

    Time frame: two and five years after RT

  8. Quality of Life (QoL)

    Patient-reported outcome measures (PROMs) EPIC-26: the Expanded Prostate Cancer Index-Short form) with score: 0-100

    Time frame: Assessments at 6, 9,12, 18, and 24 months after randomization (± 14 days for each visit) and at 30, 36, 42, 48, 54, 60 months after Ultra-hypofractionated RT - UHF (± 1 month)

  9. QoL

    Patient-reported outcome measures (PROMs) IIEF-5: The International Index of Erectile Function with score: 0-5

    Time frame: Assessments at 6, 9,12, 18, and 24 months after randomization (± 14 days for each visit) and at 30, 36, 42, 48, 54, 60 months after Ultra-hypofractionated RT - UHF (± 1 month)

  10. QoL

    Patient-reported outcome measures (PROMs) IPSS: International prostate symptom score with score 0-5

    Time frame: Assessments at 6, 9,12, 18, and 24 months after randomization (± 14 days for each visit) and at 30, 36, 42, 48, 54, 60 months after Ultra-hypofractionated RT - UHF (± 1 month)

  11. Genitourinary (GU) acute toxicities

    Cumulative acute GU toxicities using the RTOG grading system (Radiation Therapy Oncology Group; with grade: 0-5, where 0 implies no toxicity and 5 implies a side effect related to death)

    Time frame: during, 1 and 3 months after RT

  12. GU acute toxicities

    Cumulative acute GU toxicities using the CTCAE v5.0 criteria (the Common Terminology Criteria for Adverse Events criteria; with grade: 1-5 where 1 means asymptomatic or mild symptoms and 5 means death related to adverse event)

    Time frame: during, 1 and 3 months after RT

  13. GU chronic toxicities

    Cumulative chronic GU toxicities using the RTOG grading system (Radiation Therapy Oncology Group; with grade: 0-5, where 0 implies no toxicity and 5 implies a side effect related to death)

    Time frame: 6, 9, 12, 18 and 24 months after RT

  14. GU chronic toxicities

    Cumulative chronic GU toxicities using the CTCAE v5.0 criteria (the Common Terminology Criteria for Adverse Events criteria; with grade: 1-5 where 1 means asymptomatic or mild symptoms and 5 means death related to adverse event)

    Time frame: 6, 9, 12, 18 and 24 months after RT

  15. Gastrointestinal (GI) acute toxicities

    Cumulative acute GI toxicities using the RTOG grading system (Radiation Therapy Oncology Group; with grade: 0-5, where 0 implies no toxicity and 5 implies a side effect related to death)

    Time frame: during, 1 and 3 months after RT

  16. GI acute toxicities

    Cumulative acute GU toxicities using the CTCAE v5.0 criteria (the Common Terminology Criteria for Adverse Events criteria; with grade: 1-5 where 1 means asymptomatic or mild symptoms and 5 means death related to adverse event)

    Time frame: during, 1 and 3 months after RT

  17. GI chronic toxicities

    Cumulative chronic GU toxicities using the RTOG grading system (Radiation Therapy Oncology Group; with grade: 0-5, where 0 implies no toxicity and 5 implies a side effect related to death)

    Time frame: 6, 9, 12, 18 and 24 months after RT

  18. GI chronic toxicities

    Cumulative chronic GU toxicities using the CTCAE v5.0 criteria (the Common Terminology Criteria for Adverse Events criteria; with grade: 1-5 where 1 means asymptomatic or mild symptoms and 5 means death related to adverse event)

    Time frame: 6, 9, 12, 18 and 24 months after RT

  19. Dose contrainsts

    Feasibility to dose constraints for pelvic lymph nodes irradiation HDR-BT Prostate CTV=PTV Reference dose DR: 15 Gy (100 %) D90 ≥ 100 % V100 ≥ 95 % V150 ≤ 30 % Rectum (OAR) D2cc ≤ 75Gy EQD2(1.5) D1cc ≤ 70% Urethra (OAR) D0.1cc ≤ 115% D10 ≤ 110% D30 ≤ 105Gy EQD2(1.5)

    Time frame: during, 1 and 3 months after RT

  20. Dose contrainsts

    Feasibility to dose constraints for pelvic lymph nodes irradiation Pelvic EBRT PTV, Constraint, Vol cc or % PTV P/SV, V95 ≥, 95 PTV LV, V95 ≥, 95 Dmax LV, max \< 107 Dmax SIB, max \< 107 OAR: Rectum Constraint, Vol cc or % V18Gy \< (%), 50 V20Gy \< (%), 30 D1cc ≤ (Gy), 26 OAR: Sigmoid Constraint, Vol cc or % V18Gy \< (%), 50 V20Gy \< (%), 30 D1cc ≤ (Gy), 26 OAR: Bladder Constraint, Vol cc or % V18Gy \< (%), 50 V20Gy \< (%), 30 D1cc ≤ (Gy), 26 OAR: Femoral Head L Constraint, Vol cc or % D10cc ≤ (Gy), 25 OAR: Femoral Head R Constraint, Vol cc or % D10cc ≤ (Gy), 25 OAR: Bowel Cavity (including sigmoid) Constraint, Vol cc or % V25Gy \< (cc), 40 D1cc ≤ (Gy), 26 OAR: Penile bulb Constraint, Vol cc or % Mean \< (Gy), 20

    Time frame: during, 1 and 3 months after RT

  21. Dose contrainsts

    Adherence to dose constraints for pelvic lymph nodes irradiation Interruptions of RT in days along with reasons

    Time frame: during, 1 and 3 months after RT

  22. Dose contrainsts

    Adherence to dose constraints for pelvic lymph nodes irradiation Treatment not finished due to set-up problems (YES/NO) and reason

    Time frame: during, 1 and 3 months after RT

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Zamboglou C, Doncker W, Christoforou AT, Arcangeli S, Berlin A, Blanchard P, Bauman G, Campi R, Castro E, Choudhury A, Pra AD, Draulans C, Desai N, Ferentinos K, Francolini G, Gillessen S, Grosu AL, Rivas JG, Hoelscher T, Hruby G, Jereczek-Fossa BA, Kamran S, Kasivisvanathan V, Kishan AU, Kounnis V, Loblaw A, Martin J, Mastroleo F, Merseburger AS, Miszczyk M, Mohamad O, Ost P, Papatsoris A, Peeken JC, Sanguedolce F, Sargos P, Schmidt-Hegemann N, Seibert TM, Shelan M, Siva S, Soeterik TFW, Spratt DE, Stenzl A, Strouthos I, Sutera P, Supiot S, Tilki D, Tran PT, Tree AC, Tward J, Urun Y, Vapiwala N, Waddle MR, Wegener E, Zilli T, Murthy V, Thieme AH, Spohn S. oDigital pathology biomarkers for guiding radiotherapy-based treatment concepts in prostate cancer - a systematic review and expert consensus. Radiother Oncol. 2025 Sep;210:111039. doi: 10.1016/j.radonc.2025.111039. Epub 2025 Jul 9. PubMed 40645505 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 17, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06582446
Lead sponsor
German Oncology Center, Cyprus
Responsible party
Sponsor
First posted
Sep 3, 2024
Start date
Sep 16, 2024
Primary completion
Aug 31, 2027 (estimated)
Completion
Aug 31, 2027 (estimated)
Last update
Sep 17, 2026

Study contacts

Elena Pallari, PhD
Contact
elena.pallari@goc.com.cy
0035725028690
Kristis Vevis, PhD
Contact
kristis.vevis@goc.com.cy
0035725208159
Iosif Strouthos, MD
principal investigator · German Medical Institute
Constantinos Zamboglou, MD
principal investigator · German Medical Institute

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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