BACKGROUND Adding radiotherapy (RT) to systemic therapy improves progression-free survival (PFS) and overall survival (OS) in oligometastatic non-small cell lung cancer (NSCLC). Whether these findings translate to EGFR-mutated NSCLC remains unknown. The SINDAS trial (NCT02893332) evaluated first-line tyrosine kinase inhibitor (TKI) therapy for EGFR-mutated synchronous oligometastatic NSCLC, and randomized to up-front RT vs. no RT; we now report the pre-specified interim analysis at 68% accrual. METHODS Inclusion criteria were biopsy-proven EGFR-mutated adenocarcinoma (per amplification refractory mutation system or next generation sequencing), with synchronous (newly-diagnosed, treatment-naïve) oligometastatic (≤5 metastases; ≤2 lesions in any one organ) NSCLC without brain metastases. All patients received a first-generation TKI (gefitinib, erlotinib, or icotinib), and randomization was between no RT vs. RT (25–40 Gy in 5 fractions depending on tumor size/location) to all metastases and the primary tumor/involved regional lymphatics. The primary endpoint (intention-to-treat) was PFS. Secondary endpoints included OS and toxicities. All statistical tests were 2-sided. RESULTS A total of 133 patients (n = 65 TKI only, n = 68 TKI+RT) were enrolled (2016–2019). The median follow-up was 23.6 months. The respective median PFS was 12.5 months vs. 20.2 months (p < .001), and the median OS was 17.4 months vs. 25.5 months (p < .001) for TKI only vs TKI+RT. Treatment yielded no grade 5 events and a 6% rate of symptomatic grade 3–4 pneumonitis in the TKI+RT arm. Based on the efficacy results of this pre-specified interim analysis, the ethics committee recommended premature cessation of this trial. CONCLUSIONS As compared to a first-line TKI alone, addition of up-front local therapy using RT statistically significantly improved PFS and OS for EGFR-mutated NSCLC.

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A temporal cloak scheme based on tunable optical delay and advance is theoretically proposed. An input optical signal is divided into two parts, and the front part is advanced while the rear part is delayed. A temporal gap which contains negligible optical energy is opened to hide events from observers, which can be closed by doing the inverse process. Different from the previous schemes that use continuous wave light, we use an optical data stream as the probe beam. Simulations have been done to investigate performance of the temporal cloak. The developed scheme can be applied in fiber-optical signal processing and secure communications.

SUMMARY Because the permittivity, permeability, and chirality parameters of chiral metamaterials (CMMs) are frequency dependent, the wave equations that describe the characters of electromagnetic wave propagation in CMMs are presented and discretized on the basis of auxiliary differential equation technique in finite‐difference time‐domain method. The total‐field/scattered‐field, Mur's first‐order absorbing and dielectric boundary conditions for CMMs slab are discussed in the paper. Numerical results show that the cross‐polarized reflected coefficient of the CMMs slab is zero. Negative index of refraction phenomenon and optical property of giant optical activity in CMMs slabs are illustrated with 1D auxiliary differential equation–finite‐difference time‐domain method. The effects to positive or negative phase velocity caused by media parameters of CMMs are studied. Copyright © 2013 John Wiley & Sons, Ltd.

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