SBRT Induces Improved Disease Control Rates Compared With CRT in Central/Peripheral Lung Cancer

Stereotactic body radiation therapy yielded numerical improvements in terms of local control compared with conventional hypofractionated radiotherapy among patients with stage I medically inoperable non–small cell lung cancer, according to findings from the phase 3 LUSTRE trial.

Stereotactic body radiation therapy demonstrated improved local disease control rates compared with conventional hypofractionated radiotherapy in patients with central or peripheral stage I medically inoperable non-small cell lung cancer, according to results from the phase 3 LUSTRE trial.

CancerNetwork® spoke with Anand Swaminath, MD, an associate professor, clinician scientist, and radiation oncologist at Juravinski Cancer Centre in Ontario, Canada, about efficacy findings from the phase 3 LUSTRE trial (NCT01968941) that were presented at the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting.

Transcript:

When we did the final analysis, the primary objective was to determine whether stereotactic radiation controlled the cancer better as compared to conventional radiation. So, local control was our primary outcome, and that was defined radiographically. But we also had other metrics in there that allowed investigators to confirm whether the cancer was being controlled. We basically had a guide for our investigators to use PET scans or biopsies if we were suspicious that the cancer was not being controlled. That outcome was also adjudicated independently; we want to be very robust with our primary outcomes. We had a separate committee adjudicate that, and what we found with respect to controlling the cancer was that stereotactic radiation was better numerically. When we showed the comparison, there was an observed improvement, but because the trial closed early to accrual, we weren’t able to statistically confirm that. The p value was 0.15, which was showing possible improvement, but it wasn’t statistically significant, unfortunately. But, numerically, the 3-year control rates were higher with stereotactic radiation. It’s 88% with stereotactic radiation vs about 81% with conventional radiation.

Reference

Swaminath A, Parpia S, Wierzbicki M, et al. LUSTRE: a phase III randomized trial of stereotactic body radiotherapy (SBRT) vs. conventionally hypo fractionated radiotherapy (CRT) for medically inoperable stage I non-small cell lung cancer (NSCLC). Presented at 2022 American Society for Radiation Oncology Annual Meeting (ASTRO); October 23-26, 2022; San Antonio, TX. Abstract LBA 08. Accessed November 4, 2022.