2023 World Conference on Lung Cancer (Posters)-P2.03. Upfront or Delayed Cranial RT in Oncogene Mutated NSCLC with Asymptomatic Brain Metastases: A Phase III Randomized Controlled Trial

P2.03. Upfront or Delayed Cranial RT in Oncogene Mutated NSCLC with Asymptomatic Brain Metastases: A Phase III Randomized Controlled Trial - PDF(Abstract)

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This document is a summary of a presentation titled "Upfront or Delayed Cranial RT in Oncogene Mutated NSCLC with Asymptomatic Brain Metastases: A Phase III Randomized Controlled Trial" at a session on Metastatic Non-small Cell Lung Cancer - Local Therapies at the WCLC 2023 conference. The presentation discusses the treatment of patients with non-small cell lung cancer (NSCLC) who have asymptomatic brain metastases (BM). Cranial Radiation Therapy (CRT) is the standard treatment for BM, and Tyrosine Kinase Inhibitors (TKIs) have shown good intracranial control rates. However, there is debate regarding the role of upfront CRT in asymptomatic BM. Some studies have shown a superior local control and overall survival (OS) with upfront CRT and TKIs compared to TKI alone. <br /><br />To investigate this, the study is conducting a two-center, open-label phase III randomized controlled trial. 190 patients with NSCLC and asymptomatic BM with EGFR or ALK mutation will be randomly allocated to receive either TKI plus upfront CRT or TKI with delayed CRT. The primary objective is to compare intracranial progress-free survival (iPFS) at 24 months. Secondary objectives include evaluating differences in OS, PFS, local control at treated BM sites, neurocognitive toxicity, and quality of life. Additional analysis will be performed to identify predictive markers of iPFS.<br /><br />As of now, 74 patients have been accrued for the study out of 218 patients screened. The trial has received grants from TMC-Research Administrative Council and Neuro-Oncology Research Fund. The trial is registered with the clinical trial registry of India.<br /><br />In summary, this presentation discusses the ongoing phase III trial investigating the role of upfront CRT in patients with NSCLC and asymptomatic BM. The study aims to determine if upfront CRT with TKIs produces a superior iPFS compared to TKI alone with delayed CRT.

Asset Subtitle

Anil Tibdewal

Meta Tag

Speaker Anil Tibdewal

Topic Metastatic NSCLC: Local Therapies

Keywords

Upfront or Delayed Cranial RT

Oncogene Mutated NSCLC

Asymptomatic Brain Metastases

Phase III Randomized Controlled Trial

Metastatic Non-small Cell Lung Cancer

Local Therapies

Cranial Radiation Therapy

Tyrosine Kinase Inhibitors

Intracranial Control Rates

Upfront CRT vs TKI Alone