The BR38 trial testing targeted radiotherapy added to immunotherapy to improve outcomes for lung cancer patients.

The recently opened BR38 clinical trial is exploring whether adding stereotactic body radiotherapy (SBRT) to the current treatment of immunotherapy (with or without chemotherapy) can improve outcomes for patients with metastatic non-small cell lung cancer (NSCLC) and limited disease progression (oligoprogression).

“This is an important endeavor to provide additional treatment opportunities for patients with limited disease progression on immunotherapy,” says Dr. Chiaojung Jillian Tsai, the BR38 study chair and Radiation Oncologist at University Health Network and says. “By targeting the progressive tumors with precision radiation, we are hoping to get rid of the resistant tumors and thereby improving patient outcomes.”

While immunotherapy-based treatments can be very effective for this patient population, it may become less effective over time. The challenge is oligoprogression, where only a few areas of cancer are progressing while the rest remain stable. With oligoprogression, SBRT offers a way to control the isolated areas of cancer growth while allowing patients to continue their current immunotherapy.

“Radiation Oncologists in Canada and the US are receiving referrals for SBRT for patients with limited disease progression based on limited evidence of efficacy only. Consequently, it is crucial to conduct this phase III randomized trial to definitively address the effectiveness of SBRT in this context,” says Dr. Pierre-Olivier Gaudreau, the BR38 Senior Investigator.

Currently, when metastatic lung cancer progresses after immunotherapy, the usual approach is to switch to different drugs. SBRT delivers high-dose, highly precise radiation directly to cancerous tumors while minimizing exposure to surrounding healthy tissue. This targeted approach aims to control tumor growth, delay the need to change treatments, and ultimately extend the duration of treatment benefit and improve overall survival for patients.

"There are really no words to describe how important this potential new option is to those living with a lung cancer diagnosis. I personally was able to benefit from this approach, and I am thrilled to see this approach being tested so that it may be expanded potentially to other lung cancer diagnoses," says lung cancer patient representative Emi Bossio.

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