Cytoreductive Prostatectomy Combined With Triple or Dual Systemic Therapy in mHSPC Patients

This study tests whether removing the prostate (cytoreductive prostatectomy) combined with two or three systemic drug therapies — including hormone therapy and newer targeted treatments — improves survival in men with prostate cancer that has already spread to other parts of the body (metastatic hormone-sensitive prostate cancer). **You may be eligible if...** - You are a man between 18 and 75 years old - You have been diagnosed with prostate cancer confirmed by biopsy - Your cancer has spread to lymph nodes, bones, or other organs - You have not previously had local treatment (surgery or radiation) for prostate cancer - A surgeon has assessed that the prostate can be safely removed **You may NOT be eligible if...** - Your cancer has compressed the spinal cord - Your life expectancy is less than 2 years - You previously received local prostate treatment - You have difficulty swallowing or serious gastrointestinal problems that would prevent taking oral medications Talk to your doctor to see if this trial is right for you.