This clinical trial is focused on studying a type of prostate cancer known as high-risk localized or locally advanced prostate adenocarcinoma. The treatment being investigated is a medication called Darolutamide, which is also known by its code names ODM-201 and BAY 1841788. Darolutamide is an androgen receptor inhibitor, which means it works by blocking the effects of male hormones that can promote the growth of prostate cancer cells.
The purpose of the study is to assess the effectiveness of a genomic biomarker called PCAI ImmunoScore in predicting the response of prostate cancer to treatment with Darolutamide before surgery to remove the prostate, known as a radical prostatectomy. The study will observe how well the cancer responds to the treatment by looking at the amount of cancer left after treatment, referred to as minimal residual disease (MRD). Participants will take Darolutamide for a period of 90 to 120 days before undergoing surgery.
Throughout the study, researchers will also examine various factors such as changes in tumor size, blood levels of a protein called PSA (prostate-specific antigen), and any side effects related to hormone levels. The study aims to provide insights into how well the PCAI ImmunoScore can predict treatment outcomes and help tailor future treatments for prostate cancer patients. Participants will be monitored for changes in their condition and any side effects during and after the treatment period.



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