Citation: Lung Cancer. 2020, 139
Author: Lawless C.; Shaw A.; McCartney E.; Hatton M.; Faivre-Finn C.; Pope A.; Peedell C.; Simoes R.
Abstract: Introduction: Lung cancer is the most common cause of cancer mortality in the UK, and NSCLC accounts for approximately 87% of all UK lung cancers. Most patients present with inoperable disease therefore radiotherapy plays a major role in treatment. However, a large portion of patients are not suitable for gold standard treatment (concurrent chemo-radiotherapy) due to performance status and comorbidities. Novel strategies integrating radiotherapy advances and radiobiological knowledge need to be evaluated in patients treated with sequential chemo-radiotherapy. Four separate accelerated dose escalated radiotherapy schedules have been completed in the UK (CHART-ED, IDEAL-CRT, I-START and Isotoxic IMRT). ADSCaN will compare these schedules with a UK standard sequential chemo-radiotherapy schedule. A combined randomized phase II screening/'pick the winner' approach will identify the best schedule to take into a randomised phase III study against conventionally fractionated radiotherapy. Method(s): Suitable patients will have histologically/cytologically confirmed, stage III NSCLC and be able to undergo chemo-radiotherapy treatment. The study will recruit 360 patients; 130 on the standard arm and 60 on each experimental arm. Patients will complete 2-4 cycles of platinum based chemotherapy before being randomised to one of the radiotherapy schedules. Logistic/capacity challenges make it impractical for sites to open all experimental trial arms; a novel trial design allows centres to select upfront the experimental arms they are able to participate in and all will offer the standard arm. Result(s): CRUK is funding this multicentre study which is being coordinated by the CRUK CTU Glasgow. The study includes a tailored QA programme through the UK RTTQA Group. Conclusion(s): Current Status: The study opened to recruitment on 22/08/2017 with planned recruitment lasting 3 years 8 months. 20/36 sites are opened to recruitment with further sites in set up. 51 patients have been randomised to date. Disclosure: C. Peedell: honoraria for talks and presentations from Elekta; the remaining authors have declared no conflicts of interest. Figure Presented Copyright © 2020 Elsevier B.V.
