• Male subject aged \>= 18 years

• Histologically or cytologically confirmed prostatic adenocarcinoma without small cell histology

• Metastatic disease progression after continuous androgen deprivation therapy for hormone sensitive state

• Patient must have non-measurable disease outside the pelvis (above aortic bifurcation) per RECIST 1.1 criteria. Non-measurable disease can be bone lesions and/or extraskeletal disease

• Disease progression on or after at least one prior novel hormonal therapy (NHT) (defined as second-generation antiandrogen therapies that include but are not limited to abiraterone acetate, enzalutamide, apalutamide, darolutamide)

• Eastern Cooperative Oncology Group (ECOG) performance Status =\< 2

• Effective castration with serum testosterone levels =\< 0.5 ng/mL (=\<1.7 nmol/L)

• Tumor tissue available (archival or recent tumor biopsy). If no tumor tissue is available, patients can be enrolled after approval from Principal Investigator.

• Absolute neutrophil count (ANC) \>= 1500/mm\^3 without granulocyte colony-stimulating factor support

• White blood cell count \>= 2500/uL

• Lymphocyte count \>= 0.5 x 10\^9/L (500/uL)

• Platelet count \>= 100,000/mm\^3 without transfusion in the 2 weeks prior to cycle 1 day 1 (C1D1)

• Hemoglobin \>= 9 g/dL

• Serum albumin \>= 2.5 g/dl

• For patients not receiving therapeutic anticoagulation: prothrombin time (PT)/International normalized ratio (INR) or partial thromboplastin time (PTT) test \< 1.5 x institutional upper limit of normal (ULN). For patients receiving therapeutic anticoagulation: stable anticoagulant regimen as determined by Investigator

• Total bilirubin =\< 1.5 x institutional upper limit of normal (ULN). For subjects with Gilbert's disease =\< 3 x institutional ULN

• Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase \[SGOT\]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 2.5 × institutional ULN

⁃ Subjects with liver metastases will be allowed to enroll with AST and ALT levels =\< 5 x institutional ULN

• Alkaline phosphatase (ALP) =\< 3 × institutional ULN. Patients with documented liver or bone metastases: ALP =\< 5 x institutional ULN

• Serum creatinine =\< 1.5 x institutional ULN or calculated creatinine clearance \>= 40 mL/min by Cockcroft-Gault formula

• Urine protein/creatinine ration (UPCR) =\< 1mg/mg (=\< 113.2 mg/mmol), or 24-hour (h) urine protein =\< 1 g

• Sexually active fertile subjects and their partners must agree to use medically accepted methods of contraception (e.g., barrier methods, including male condom, female condom, or diaphragm with spermicidal gel) during the course of the study and for 5 months after the last dose of study treatment

• Male subjects must agree to use a condom during intercourse for the duration of study therapy

• Recovery to baseline or =\< grade 1 Common Terminology Criteria for Adverse Events (CTCAE) v5.0 from toxicities related to any prior cancer therapy, unless considered clinically not significant by the treating investigator and/or stable on supportive therapy

• Able to provide informed consent and willing to sign an approved consent form that conforms to federal and institutional guidelines

• Capable of understanding and complying with the protocol requirements