What is a clinical trial?

A clinical trial is a research study involving human participants designed to evaluate medical interventions — such as drugs, devices, or behavioral strategies. Trials follow a structured protocol and are registered on ClinicalTrials.gov. They progress through phases: Phase 1 (safety), Phase 2 (efficacy), Phase 3 (large-scale comparison), and Phase 4 (post-market surveillance).

How do I find clinical trials I'm eligible for?

You can search ClinicalTrials.gov or use ClinicalMetric to filter by condition, phase, or location. Each trial listing includes eligibility criteria such as age range, sex, diagnosis, and prior treatment history. Contact the study team directly or ask your physician to refer you to a relevant trial.

Are clinical trials safe to participate in?

Clinical trials are conducted under strict ethical and regulatory oversight, including IRB approval and FDA regulation in the US. All participants must give informed consent after reviewing potential risks and benefits. Phase 1 trials carry more uncertainty, while Phase 3 trials involve interventions with an established safety profile. Participation is always voluntary and you may withdraw at any time.

What are the phases of clinical trials?

Clinical trials progress through four main phases. Phase 1 tests safety and dosing in a small group (20–80 people). Phase 2 evaluates efficacy and side effects in a larger group (100–300). Phase 3 compares the intervention against standard treatments in thousands of participants. Phase 4 occurs after approval and monitors long-term effects in the general population.

Do participants get paid for joining clinical trials?

Many clinical trials offer compensation for time and travel expenses, though payment structures vary widely by study. Compensation is not intended to be coercive. Some trials also cover treatment costs for participants. Always review the consent form carefully and ask the study coordinator about any financial considerations before enrolling.

Prostate Cancer Clinical Trials 2026: PARP Inhibitors, PSMA Therapy & mCRPC

Medical Notice

This article is for informational purposes only and does not constitute medical advice. Clinical trial eligibility and availability vary. Always consult a qualified healthcare professional before making any medical decisions or considering participation in a clinical trial.

Summary

Prostate cancer treatment has been transformed over the past five years by PSMA-targeted radioligand therapy, PARP inhibitors for DNA repair-deficient tumors, and more potent androgen receptor pathway inhibitors. In 2026, over 500 prostate cancer trials are recruiting — spanning localized disease surveillance, hormone-sensitive metastatic disease, and castration-resistant prostate cancer (mCRPC). Understanding your disease stage, prior treatment history, and molecular profile is essential for navigating this landscape.

PSMA-Targeted Therapy

Lutetium-177 PSMA-617 (Pluvicto) was approved in 2022 for PSMA-positive mCRPC after prior ARPI and taxane therapy. It delivers targeted radiation directly to PSMA-expressing prostate cancer cells. In 2026, trials are investigating:

Earlier use in hormone-sensitive metastatic prostate cancer (PSMA4 trial)
Actinium-225 PSMA — a more potent alpha-emitter version, Phase 2 trials showing striking response rates in heavily pre-treated patients
PSMA-directed CAR-T cell therapy — Phase 1 trials beginning
Combination with PARP inhibitors or immunotherapy

PSMA PET scan (Pylarify, Illuccix) is required to confirm PSMA expression before most PSMA-targeted therapy trials. Ask your oncologist about PSMA PET if you have metastatic prostate cancer.

PARP Inhibitors and DNA Repair Mutations

Olaparib (Lynparza) and rucaparib (Rubraca) are approved for BRCA1/2-mutated mCRPC. Approximately 20–25% of mCRPC patients have homologous recombination repair (HRR) gene mutations (BRCA1/2, ATM, CDK12, CHEK2). Current trials are testing PARP inhibitors in earlier disease stages and in combination with PSMA therapy and immunotherapy. Niraparib + abiraterone (Akeega) was approved for BRCA-mutated mCRPC in 2023 — trials for broader HRR populations are ongoing.

Androgen Receptor Pathway Trials

Next-generation AR inhibitors and novel AR-targeting mechanisms are in trials. AR splice variant 7 (AR-V7) drives resistance to enzalutamide and abiraterone — drugs targeting this splice variant are in Phase 1/2. Bispecific antibodies targeting PSMA and CD3 (T cell engagers) are showing activity in early trials. AKT inhibitors in combination with enzalutamide are in Phase 3 for PTEN-deleted tumors.

Biomarkers to Know Before Searching for Trials

For prostate cancer trial eligibility, ensure you have: germline BRCA1/2 testing (blood), somatic tumor molecular profiling (tissue biopsy or liquid biopsy for HRR mutations, MSI-H/dMMR, CDK12), PSMA PET scan results, PSA doubling time, and prior treatment history (ARPI exposure, taxane exposure). Many mCRPC trials require specific prior treatment sequences.