RadiaNCe Lung X Trial Combines Radiation and Targeted Therapy to Delay Lung Cancer Progression

PhotomicrographThe MCW Cancer Center’s Clinical Trials Office has activated the phase 2 RadiaNCe Lung X trial, led by Jonathan Thompson, MD, MS, Associate Professor of Hematology and Oncology, that evaluates whether combining radiation with targeted drug therapy can delay cancer progression in patients with driver-mutated non-small cell lung cancer (NSCLC). If successful, the investigator-initiated trial could introduce a promising new treatment approach to improve outcomes for patients with advanced disease.

“Our study focuses on patients with advanced NSCLC who have ‘driver mutations,’ which accelerate cancer growth,” explained Dr. Thompson. “These patients typically respond well to targeted therapies at first, but over time, resistance develops, and the cancer starts progressing, leading to a poorer prognosis. In RadiaNCe Lung X, we’re adding radiation to the main lung tumor before starting the targeted therapy in hopes of shrinking it and delaying resistance.”

Historically, the standard treatment for advanced NSCLC has involved chemotherapy or targeted therapies such as tyrosine kinase inhibitors (TKIs), which block signals that allow cancer cells to grow and spread. While TKIs have been highly effective in prolonging survival for patients with driver mutations, they often fail to completely eliminate large tumors, which eventually leads to treatment resistance. “The primary lung tumor is usually the bulkiest area of cancer, and because targeted therapies can’t completely get rid of these bulky areas, that’s where we see resistance developing,” explained Dr. Thompson. “By using radiation to debulk the main tumor, we’re hoping to prolong the effectiveness of the targeted therapy.”

Lung cancer remains the leading cause of cancer-related deaths in the United States, with NSCLC being the most common type. Precision medicine has offered hope to patients with driver-mutated NSCLC, particularly younger individuals who are often diagnosed despite minimal or no smoking history. Dr. Thompson emphasized that while targeted therapies have revolutionized treatment, resistance remains a critical challenge. “If we can demonstrate that radiation delays drug resistance, this concept could be applied broadly to other cancers where precision medicine is used,” he said.

The study team aims to enroll 29 patients over 18 months, with sites at Froedtert’s main campus and community locations including Menomonee Falls, West Bend, and Drexel Town Square, to ensure broader access to this promising treatment.