Findings From LUSTRE Trial Confirm SBRT a ‘Good Alternative’ to Conventional Radiation for Inoperable Lung Cancer, Says Expert

Stereotactic body radiotherapy (SBRT) may serve as a safe and effective alternative to conventional hypofractionated radiotherapy (CRT) to treat patients with stage I inoperable non-small cell lung cancer, according to Anand Swaminath, MD.

During the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting, Swaminath spoke with CancerNetwork^® about data from the phase 3 LUSTRE trial (NCT01968941), which he said supports the fact that more and more oncologists are using SBRT to treat their patients with early-stage inoperable non-small cell lung cancer.

Investigators in the LUSTRE trial compared SBRT with CRT to assess local disease control, which was defined as the absence of primary tumor or marginal failure. The 3-year local control rate for SBRT and CRT, respectively, was 87.6% and 81.2% (HR, 0.61; 95% CI, 0.31-1.20; P = .15).

Swaminath, an associate professor, clinician scientist, and radiation oncologist at Juravinski Cancer Centre in Ontario, Canada, concluded that the findings provide treating physicians guidance on how to best treat patients they consider at greater risk for adverse events.

Transcript:

Stereotactic radiation for both central and peripheral lung cancer is safe. It's effective. It's probably a good alternative to conventional radiation, even if it's done in 15 days. There is an opportunity here to evaluate the patients with central tumors more robustly to ensure that the community is comfortable treating them safely. That reaffirms our practice, because a lot of people are doing stereotactic radiation already, so it reaffirms that what we're doing is safe and effective. But it also gives us guidance on how we can treat those patients [for] whom we're considering that there might be a higher risk of toxicity. All in all, I think it was a trial that answered a lot of good questions and taught us a lot of good lessons.

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.