• Histologically or cytologically confirmed localized prostatic adenocarcinoma. Patients with primarily neuroendocrine/small cell histology will be excluded.

• Patients with prostatic adenocarcinoma in one of the following risk groups as defined by NCCN criteria:

‣ Unfavorable intermediate risk. Intermediate risk is defined as having no high-risk or very high-risk factors and having at least one of the following intermediate risk factors (IRFs):

• cT2b-cT2c

∙ Grade Group 2 or 3

∙ PSA 10-20 ng/mL

∙ Unfavorable intermediate risk additionally must have one or more of the following:

‣ 2 or 3 IRFs

⁃ Grade Group 3

⁃ ≥50% biopsy cores positive (eg, ≥ 6 of 12 cores) OR

⁃ High-risk, which is defined as not meeting very high-risk criteria and having at least one of the following high-risk features:

• cT3-cT4

∙ Grade Group 4 or 5

∙ PSA \> 20 ng/mL OR

⁃ Very high-risk, which is defined as meeting at least two of the following criteria:

• cT3-cT4

∙ Grade Group 4 or 5

∙ PSA \> 40 ng/mL\

• Willing and able to undergo prostate MRI at baseline, with a measurable prostate lesion present.

• Planning to undergo radical prostatectomy as primary treatment for localized prostate cancer.

• At least 18 years of age.

• ECOG performance status ≤ 1

• Adequate bone marrow and organ function as defined below:

‣ Leukocytes ≥ 3.0 K/cumm

⁃ Absolute neutrophil count ≥ 1.5 K/cumm

⁃ Platelets ≥ 100 K/cumm

⁃ Total bilirubin ≤ 1.5 x institutional upper limit of normal (IULN)

⁃ AST(SGOT)/ALT(SGPT) ≤ 3.0 x IULN

⁃ Estimated glomerular filtration rate eGFR ≥ 30 mL/min/1.73m\^2

• Agreement to adhere to Lifestyle Considerations throughout study duration

• Ability to understand and willingness to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable).