Immunotherapy or Targeted Therapy With or Without Stereotactic Radiosurgery for Patients With Brain Metastases From Melanoma or Non-small Cell Lung Cancer
Condition(s) studied
Investigational drug(s) / intervention(s)
Stereotactic radiosurgery: Depending on the investigator's preference, the following standard of care fractionation schedules are recommended: 1x 18-22 Gy, 3x 9 Gy or 5x 6 Gy. Fractionated stereotactic radiotherapy is favoured in principle, but not mandated, for postoperative radiotherapy and for metastases with a diameter of \>20 mm or for \>4 brain metastases. For patients randomised to Arm A, radiotherapy should be initiated within 14 days after randomisation.
Immune checkpoint inhibitor: Systemic therapy follows the current standard of care, according to the type of the primary tumour. * For patients with melanoma, with or without BRAF-mutation, systemic therapy consists of * an approved immune-checkpoint inhibition combination therapy (cohort 1a) or * an approved immune-checkpoint inhibition monotherapy (cohort 1b). * For patients with NSCLC and a targetable oncogenic driver alteration (cohort 2a), systemic therapy consists of an approved targeted therapy (for example: EGFR-, ALK- or ROS1-targeted treatment). * For patients with NSCLC without a targetable oncogenic driver alteration (cohort 2b), systemic therapy consists of an approved immune-checkpoint inhibition therapy (with or without chemotherapy).
Study summary
The primary objective of the study is to assess the efficacy in terms of CNS-specific PFS of the combination of standard systemic treatment plus SRS vs. standard systemic treatment alone in patients with newly diagnosed and untreated (except for surgery) asymptomatic or oligosymptomatic brain metastases from melanoma or NSCLC. This proposed randomised phase III clinical study addresses one of the most controversial issues in the current approach to patients with brain mets: the timing of SRS in patients eligible for systemic immune checkpoint inhibition or targeted therapy in order to guide therapeutic options as to what strategy allows the best compromise between best survival and best QoL.
Eligibility
Primary outcome measure(s)
- CNS-specific PFS, locally assessed as per iRANO criteria — from date of randomization until the date of documented CNS-specific progression, assessed up to 42 months
The primary objective of the study is to assess the efficacy in terms of CNS-specific progression-free survival (PFS) of the combination of standard systemic treatment plus SRS versus standard systemic treatment alone in patients with newly diagnosed and untreated (except surgery) asymptomatic or oligo-symptomatic brain metastases from melanoma or non-small cell lung cancer, with indication for systemic therapy.
Trial sites (15)
| Facility | City | Region | Status |
|---|---|---|---|
| Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale" | Naples | Italy | Recruiting |
| Instituto Oncologico Veneto IRCCS | Padova | Italy | Not Yet Recruiting |
| Santa Maria della Misericordia Hospital | Perugia | Italy | Recruiting |
| Istituto Nazionale Tumori "Regina Elena" | Roma | Italy | Recruiting |
| Policlinico Umberto 1 | Rome | Italy | Recruiting |
| Azienda ospedaliero-universitaria Senese Siena | Siena | Italy | Recruiting |
| NKI-AVL | Amsterdam | Netherlands | Recruiting |
| Vall Hebron Institute of Oncology (VHIO) | Barcelona | Spain | Recruiting |
| Hospital Puerta de Hierro | Majadahonda | Spain | Recruiting |
| Hospital La Fe | Valencia | Spain | Recruiting |
| Inselspital | Bern | Switzerland | Recruiting |
| Kantonsspital Winterthur | Winterthur | Switzerland | Recruiting |
| Universitätsspital Zürich | Zurich | Switzerland | Recruiting |
| Royal Marsden (Sutton) | London | United Kingdom | Recruiting |
| Christie NHS Manchester | Manchester | United Kingdom | Recruiting |
More ETOP IBCSG Partners Foundation trials in Italy
Other trials for the same condition
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
View NCT05522660 on ClinicalTrials.gov ↗ ← All trials in Italy