Phase II Trial of Stereotactic Body Radiation Therapy Combined With Erlotinib for Patients With Limited but Progressive Metastatic Non–Small-Cell Lung Cancer

Abstract

Use of SBRT with erlotinib for unselected patients with stage IV NSCLC as a second- or subsequent line therapy resulted in dramatic changes in patterns of failure, was well tolerated, and resulted in high PFS and OS, substantially greater than historical values for patients who only received systemic agents.

In silico comparison of photons versus carbon ions in single fraction therapy of lung cancer

“…Furthermore, a study made by Kadoya reached the same conclusion as our study, that patients with larger CTV and/or multiple CTVs would receive less dose from proton therapy [Kadoya et al, 2010]. A recent phase II trial for patients with multiple sites of extracranial disease showed good results for photons [Iyengar et al, 2014], however, based on the findings of Kadoya et al and our study, proton and/or carbon-ion therapy might result in even better outcome.…”

“…Furthermore, several studies have shown that SBRT can be used in the setting of limited metastatic disease [Rusthoven et al, 2009, Villaruz et al, 2012, Salama et al, 2012, Iyengar et al, 2014.…”

“…The prognosis is poor, with a median survival of only 9 months and less then 25% of the patients survive the first year after the disease is diagnosed [Tsao, 2016]. A recent phase II trial combined chemotherapy with stereotactic body radiation therapy and showed promising results with 20 months overall survival [Iyengar et al, 2014]. …”

Management of non-small cell lung cancer with EGFR mutation: the role of radiotherapy in the era of tyrosine kinase inhibitor therapy—opportunities and challenges

“…These encouraging results indicated that radiotherapy might aid expansion the effectiveness of TKI therapy in those patients who are responding to TKI treatment. In another two studies using TKI combined with radiotherapy in stage III/ IV NSCLC, although enrolled patients was not selected based on the EGFR mutation status, the median PFS of 10-14 months and survival time of 20-22 months were observed with acceptable toxicities, indicated the feasibility of targeted therapy combined with advanced radiotherapy in clinical practice (33,34). Recently, we launched a phase II trial of hypofractionated radiotherapy for limited metastatic NSCLC harboring sensitizing EGFR mutations, the inclusion patients are required to be oligometastatic disease (≤5 discrete lesions of disease, exclusive of the brain metastases) after 3 months of TKI therapy, evaluated by PET/CT scan.…”

Is there a benefit to locally consolidative therapy for oligometastatic non-small cell lung cancer?

“…The authors reported a median PFS of 12.1 months and OS of 13.5 months, although there were six patients who remained free from progression at 2 years (11). Two other smaller-size phase II trials of SBRT in combination with either chemotherapy or erlotinib showed PFS durations of 11.2 and 14.7 months, respectively, with OS durations of 23 and 20.4 months, respectively (12,13).…”