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Minesh P. Mehta, MD, on NSCLC: Tumor Treating Fields for Brain Metastases

2024 ASCO Annual Meeting

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Minesh P. Mehta, MD, of Miami Cancer Institute, part of Baptist Health South Florida, discusses results from the METIS (EF-25) trial evaluating the efficacy and safety of tumor treating fields therapy following stereotactic radiosurgery in patients with mutation-negative non–small cell lung cancer (NSCLC) and brain metastases. Tumor treating fields therapy prolongs time to intracranial disease progression and may postpone whole-brain radiation therapy without declines in quality of life and cognition (Abstract 2008).



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
It's a pleasure to be here today to talk about the EF-25 METIS trial. This was a clinical trial evaluating the use of tumor treating fields therapy in patients with non-small cell lung cancer with brain metastasis that are mutation negative. Just under 300 patients, 298 to be precise, were randomized to receiving stereotactic radiosurgery, which is the standard of care for these patients, but is characterized with high rate of intracranial relapse. Following stereotactic radiosurgery, patients received best supportive care in the control arm or best supportive care plus tumor treating fields therapy. The primary endpoint of the trial was to determine if the rate of intracranial progression and the time to intracranial progression could be altered with the use of tumor treating fields therapy. And in fact, the key top line result of the trial was indeed precisely that. The time to intracranial progression was significantly lengthened in favor of tumor treating fields by 10.6 months, and therefore the median time to progression was 10.3 months in the control arm and 21.9 months in the experimental or tumor treating fields arm. This was a significant prolongation. In association with this prolongation of tying to intracranial progression, quality of life metrics also favored tumor treating fields therapy. There was a greater sustenance of quality of life and a greater durability of quality of life in patients receiving tumor treating fields therapy. Overall, the safety was exceptionally well tolerated. Only 2.3% of patients experienced grade three or higher toxicities that were device related. This is a very well tolerated therapy and prolongs time to intracranial progression, which is the top line result. Other secondary endpoints are currently being evaluated and we look forward to reporting those out shortly.

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