Last year in the UK over 60,000 cancer patients enrolled on clinical trials aimed at improving cancer treatments and making them available to all.
A trial looking at the treatment of lung cancer which has spread to the brain (Quartz)
Please note - this trial is no longer recruiting patients. We hope to add results when they are available.
This trial is trying to find out which treatment combinations give the best
If you have lung cancer that has spread to your brain, your doctors and nurses will offer you advice and support. This is called optimal supportive care and will include treatment with steroids. In the past, doctors also gave a course of radiotherapy to the brain.
But although radiotherapy for secondary brain cancer can improve some symptoms, it does cause side effects. So overall doctors are not sure if radiotherapy to the brain is helpful in this situation or not.
In this trial people with non small cell lung cancer that has spread to the brain, will either have
- Optimal supportive care and steroid treatment
- Optimal supportive care, steroid treatment and radiotherapy to the brain
The aim of the trial is to find out which treatment is better for people with lung cancer that has spread to their brain.
Who can enter
You can enter this trial if you
- Have non small cell lung cancer that has spread to your brain
- Cannot have an operation to remove the cancer in your brain
- Are well enough to take part in the trial
- Have had treatment with an EGFR inhibitor, as long as there is a one week gap since taking your last tablet
- Have had chemotherapy as long as there is a 4 week gap since your last treatment
- Are at least 18 years old
You cannot enter this trial if you
- Have had radiotherapy to your brain in the past
- Have had surgery to remove cancer from your brain in the last 4 weeks
- Have another medical condition which is not under control, and the researchers think will affect your treatment, or the results of this trial
This is a randomised trial. It will recruit over 500 patients into 2 groups. The people taking part are put into a treatment group by a computer. Neither you nor your doctor will be able to decide which group you are in.
If you are in group 1 you will get support from members of your health care team, such as your GP, physiotherapist and specialist nurses. This is called optimal supportive care. You will also continue to take a steroid called dexamethasone as part of your treatment.
If you are in group 2 you will get optimal supportive care, and you will take the steroid dexamethasone. You will also have radiotherapy to your brain.
Everyone taking part in the study will be monitored closely to see how they are. One of the research team will telephone you weekly for 12 weeks, and then about once every 4 weeks after that. They will ask you about how you are feeling, and about any side effects you have had.
If you agree, the researchers would also like to telephone your main carer, about once a week for 12 weeks, and then every 4 weeks after that. The researcher will ask your carer how they are feeling. They will also ask them some questions about how you are.
You will also go to the hospital to see the doctors. One of the research team will ask you questions about how you are feeling. They will also ask your carer some questions, if they are taking part in the study.
If you are in group 2, you will have radiotherapy once a day, for 5 days. You have this as an outpatient and you will not have to stay in hospital overnight.
If you are well enough, you will carry on going to the hospital to see the doctors. You will see them about every 4 weeks, or more often if needed. The trial doctors and nurses will ask you about your symptoms which helps them decide what dose of steroids would work best for you.
As with most cancer treatments, radiotherapy and dexamethasone have some side effects.
The most common side effects of the steroid dexamethasone are
- Increase in appetite
- Fluid retention
- Muscle weakness
- Difficulty sleeping (if taken late at night)
- Mood swings
- Increased blood sugars
- An infection called candida or 'thrush' (especially in the mouth)
The most common side effects of radiotherapy to the brain are
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Dr Paula Mulvenna
Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
Medical Research Council (MRC)
NIHR Clinical Research Network: Cancer
University College London (UCL)
This is Cancer Research UK trial number CRUK/07/001.