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(Slides)

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This document provides an update on an ongoing Phase III randomized controlled trial for the treatment of oncogene driver mutated non-small cell lung cancer (NSCLC) patients with asymptomatic brain metastases (ABM). The trial is investigating the role of upfront cranial radiation therapy (CRT) versus delayed CRT in these patients. The study aims to determine if upfront CRT improves intracranial control compared to delayed CRT at the time of progression in NSCLC patients receiving tyrosine kinase inhibitors (TKIs). <br /><br />The trial includes patients with ABM and oncogene mutation, excluding those with prior brain radiation therapy, brainstem metastases, or leptomeningeal disease without brain metastases. The technique of CRT depends on the number of brain metastases and physician preference. The primary objective of the trial is to assess intracranial progression-free survival (iPFS) at 24 months. Secondary objectives include overall survival, progression-free survival, local control at treated brain metastasis sites, neurocognition, and quality of life.<br /><br />The study has a sample size of 190 patients and hypothesizes that upfront CRT will result in improved intracranial control compared to delayed CRT in oncogene mutated NSCLC patients receiving TKIs. Stratification is done based on the GRADE (GPA) score and whether the brain metastases are synchronous or metachronous.<br /><br />The trial is being conducted at multiple centers and is funded by TMC-TRAC and Neuro-Oncology Research Fund. The principal investigator is Anil Tibdewal from Tata Memorial Hospital in Mumbai, India.<br /><br />Overall, this study aims to provide valuable insights into the optimal treatment approach for NSCLC patients with asymptomatic brain metastases and oncogene mutations, with the potential to improve intracranial control and patient outcomes.

Asset Subtitle

Anil Tibdewal

Meta Tag

Speaker Anil Tibdewal

Topic Metastatic NSCLC: Local Therapies

Keywords

Phase III

randomized controlled trial

oncogene driver mutated

non-small cell lung cancer

asymptomatic brain metastases

cranial radiation therapy

tyrosine kinase inhibitors

intracranial control

progression-free survival

sample size