Addition of Hypofractionated High Dose Radiation in Oligometastatic Disease

Trial statusRecruiting
Trial phasePhase 3
Trial typeInterventional
Biological sexAll
Age18+
SponsorVastra Gotaland Region

About this trial

This is a 2:1 randomized multicentre open label phase III study of radiation combined with standard systemic treatment compared with systemic treatment alone in oligometastatic (≤5 metastases) NSCLC. Stratification factors: performance status, gender and systemic strategy. The systemic treatment consists of chemotherapy/chemoimmunotherapy or immunotherapy and is given according to local practice. During the first 3 months of systemic treatment, aiming to start around the 2nd cycle is radiotherapy delivered to all known lesions. Preferably with SBRT /SRT/SRS but conventional radiotherapy may also be used. After the first three cycles of systemic treatment, the patients are assessed, and after four cycles, they are continuing maintenance therapy if indicated. The patients are followed with radiology every three months.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Written informed consent obtained from the subject prior to performing any protocol- related procedures, including screening procedures

Histological or cytological diagnosis of NSCLC

Stage IV disease with ≤5 metastases (not including primary tumour or mediastinal nodes, N1-N3)

Patient deemed fit for first line chemoimmunotherapy, immunotherapy or chemotherapy

Disqualifiers

• Solitary brain lesion or contralateral lung lesion as the only distant metastasis

Participation in another clinical study with an investigational product during the last 4 weeks

Patients with EGFR+, ALK+, ROS1+ disease or any other genetic alteration that would result in a TKI based first line treatment (i.e. first line treatment not being chemoimmuno- or immunotherapy)

Malignant pleural fluid, or ascites (malignant cells or clinical judgement) or excessive fluid hampering radiation according to protocol

Trial design

Design model

Parallel

Treatments tested in this trial

  • Standard systemic therapy + radiotherapy

    Other intervention

    Combined systemic therapy + radiation

  • Standard systemic therapy

    Drug

    Chemoimmunotherapy or immunotherapy

Treatment groups

240 Participants
are divided into 2 treatment groups
Group A: A, standard systemic therapyActive comparator 1 intervention
Group B: B, Radiotherapy + systemic therapyExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Overall survival (OS)

Time to death

Time frame
From date of randomization until the date of death from any cause, whichever came first, assessed up to 60 months

Secondary outcomes

1

Progression-free survival (PFS)

Time to progressive disease or death

Time frame
From date of randomization until the date of first documented systemic progression or date of death from any cause, whichever came first, assessed up to 60 months
2

Local control (LC)

Percentage complete, partial remission or stable disease

Time frame
At 12 months after randomization

Other outcomes

Sponsors and contacts

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