First-line TKI with or without RT for synchronous oligometastatic EGFR-mutated NSCLC

Addition of radiotherapy to systemic therapy is associated with improved progression-free survival and overall survival of patients with oligometastatic non-small cell lung cancer. Whether these findings translate to EGFR-mutated NSCLC is unknown. The SINDAS trial (Sichuan Provincial People’s Hospital, Chengdu) evaluated first-line TKI with or without upfront RT for EGFR-mutated synchronous oligometastatic NSCLC. Prespecified interim analysis of the trial showed that addition of RT to TKI was associated with improved PFS and OS, without grade 5 toxicities and with symptomatic grade 3 or 4 pneumonitis in 6% of patients in the TKI + RT group. Based on the results of the interim analysis the ethics committee recommended premature cessation of the trial.