Relugolix and Enzalutamide in Combination With Radiation Therapy for the Treatment of Very High Risk Prostate Cancer, OPTIMAL Trial

This study (called OPTIMAL) is testing whether combining the hormone-blocking drugs relugolix and enzalutamide with radiation therapy produces better outcomes than standard hormone therapy plus radiation for men with very high-risk prostate cancer. **You may be eligible if...** - You are 18 or older with biopsy-confirmed prostate adenocarcinoma meeting NCCN "very-high-risk" criteria (advanced stage, high-grade cancer, or multiple high-risk features) - Pelvic lymph node involvement is allowed, provided it is below a certain level - Your testosterone level is above the normal threshold at enrollment - Your general health and organ function are adequate for treatment **You may NOT be eligible if...** - Your cancer has spread to distant organs (metastatic disease) - You have already received hormone therapy for prostate cancer (some short-term exceptions may apply) - You have serious heart conditions or other illnesses that would make the treatment unsafe - You are unable to comply with radiation therapy appointments Talk to your doctor to see if this trial is right for you.