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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Wednesday, June 26, 2024
Stereotactic radiosurgery followed by supportive care with vs without tumor-treating fields therapy was found to significantly prolong the duration of time to intracranial disease progression in patients with mutation-negative non–small cell lung cancer (NSCLC) and brain metastases, without a decline in quality of life and cognition, based on the results of the multicenter phase III METIS (EF-25) trial. At the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 2008), Minesh P. Mehta, MD, of Baptist Health South Florida, Miami, and colleagues suggested that, with such salvage therapy, it may be feasible to postpone whole-brain radiotherapy.
“Whole-brain radiotherapy reduces intracranial failure but is used less frequently because of cognitive consequences,” the investigators remarked. “Tumor-treating fields are electric fields that disrupt cancer cell division and have shown improved survival and safety in patients with glioblastoma and metastatic NSCLC.”
Between July 2016 and September 2022, a total of 298 patients with 1 to 10 brain metastases (median age, 63.5 years) were randomly assigned in a 1:1 ratio to receive stereotactic radiosurgery followed by best supportive care with or without 150 kHz of tumor-treating fields therapy. The median duration of tumor-treating fields therapy was 16 weeks, with a median usage time of 67%.
The duration of time to intracranial disease progression from stereotactic radiosurgery seemed to be significantly prolonged with vs without tumor-treating fields therapy (median, 21.9 vs 11.3 months; hazard ratio = 0.67; P = .02). According to the investigators, adverse events related to tumor-treating fields therapy were mainly dermatologic and of grade 2 or lower. Tumor-treating fields therapy was found to improve deterioration-free survival, physical functioning, and fatigue; it did not appear to negatively impact cognition.
Disclosure: For full disclosures of the study authors, visit coi.asco.org.
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