Efficacy and Safety of Apalutamide in Combination With 89Sr as Neoadjuvant Therapy in Prostate Cancer With ≤10 Bone Metastases

This study is testing whether combining apalutamide (a hormone-blocking drug for prostate cancer) with strontium-89 (a radioactive treatment that targets bone metastases) before surgery can improve outcomes for men with prostate cancer that has spread to a small number of bones (10 or fewer). **You may be eligible if...** - You have been confirmed to have prostate cancer by biopsy - Bone scans show you have 10 or fewer bone metastases - You agree to have surgery (laparoscopic radical prostatectomy plus lymph node removal) - You are willing to have hormone therapy before and after surgery - Your general health is good (ECOG score 0–1) **You may NOT be eligible if...** - You have any other tumor requiring treatment at the same time - Imaging shows cancer spread to organs other than bone (such as liver or brain), or risk of spinal cord compression - You have a history of epilepsy or conditions that may cause seizures - You have severe liver, kidney, heart, or immune system disease Talk to your doctor to see if this trial is right for you.