Radiation therapy: A game-changer for metastatic lung cancer treatment at one-tenth the investment

MedTech & Diagnostics News: A new study has revealed the tremendous potential of radiation therapy as a promising new treatment option for patients diagnosed with metastatic lung cancer, igniting excitement within the medical community.

Peter MacCallum Cancer Centre’s SAFRON II clinical trial, which focused on patients with pulmonary oligometastases (up to three metastasised cancer spots in the lungs), has now released long-term survival data. Instead of opting for conventional surgery or ongoing drug therapy, participants in the trial received Stereotactic Ablative Body Radiotherapy (SABR), a highly precise and high-dose radiotherapy.

The long-term data demonstrates that one-third of patients were free of active cancer after five years of treatment. These individuals have been enjoying an excellent quality of life without the need for ongoing treatments, marking a significant breakthrough in cancer care.

The pivotal role of radiation therapy in clinical best practice has often been overlooked by the government. A report commissioned by Varian and supported by Lung Foundation Australia highlighted that radiation therapy has a critical role in curing 40% of all cancers, representing a best-practice treatment for 48% of cancer diagnoses, and remarkably costing only 6 cents for every dollar invested by the government in cancer treatment. However, only 20% of cancer patients who should receive radiation therapy currently have access to it.

Furthermore, the report delved into the substantial financial and productivity setbacks linked to traveling to treatment centres, particularly affecting rural and remote patients. Not only are patients required to take time away from their lives and livelihoods, they also often must cover the costs of travel and accommodation. An estimated 31% of eligible patients forego radiation therapy due to insufficient support for transport and accommodation.

Associate Professor Shankar Siva, study Chair, emphasised that the SAFRON II trial presented the most robust evidence to date for any targeted cancer treatment involving lung metastases. In comparison to lifelong drug therapies, which are often the standard alternatives, SABR has a minimal impact on patients’ quality of life.

“This trial shows exceptional long-term outcomes, and we believe this approach to treatment has great promise,” A/Prof Siva remarked.

The study also revealed that SABR is approximately 10 times less costly and can be administered in just one to four hour-long visits, eliminating the need for ongoing cycles of therapy.

“Notably, these costs are predominantly in the pre-immunotherapy era; of the 96 drugs used post-progression, only eight (8%) were immunotherapy. It would be expected that this difference in cost would likely be magnified in the current era,” the authors said.

One patient, John Higgins, 70, who had previously undergone a lung removal surgery after being diagnosed with lung cancer 12 years ago, experienced the benefits of SABR. A few years later, cancer emerged in his trachea and subsequently spread to his remaining lung. Having previously endured the adverse effects of chemotherapy, which led to kidney failure, Mr Higgins found SABR to be a far more tolerable treatment option.

The trial results were presented by A/Professor Siva at the European Society for Radiotherapy and Oncology conference last month. Simultaneously, the findings were published in the Journal of Clinical Oncology, providing extensive evidence on the long-term outcomes of trial participants from 13 centres across Australia and New Zealand.

The single-fraction lung SABR treatment was initially pioneered at Peter MacCallum Cancer Centre and has since been introduced nationwide over the past decade. A/Prof Siva has previously led the use of SABR in treating inoperable primary renal cell carcinoma.

Supported by Cancer Australia, the study was led by Peter MacCallum Cancer Centre as the primary institution for the TranTasman Radiation Oncology Group trial conducted across Australia and New Zealand.

This research marks a significant stride in the fight against lung cancer, offering hope and improved treatment options for patients.

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