Lung Cancer - MSK 21-465

The purpose of this study is to assess the use of local ablative therapy (LAT) in people with metastatic non-small cell lung cancer (NSCLC) and minimal residual disease (MRD). MRD is when a very small number of cancer cells can be detected in the blood, which indicates the patient's cancer as a high chance of getting worse. In this study, patients will receive LAT when their MRD levels are rising. LAT is treatment that focuses on and destroys tumors in a certain area of the body (rather than throughout the entire body, like systemic therapy). LAT can include radiation therapy, surgery, and/or radiofrequency ablation (using a needle-like probe and high-energy radio waves to destroy cancer cells). It is hoped that LAT is useful during the earliest "pre-progression" stage of cancer in the blood, can reduce MRD levels, and can control metastatic NSCLC longer than systemic therapy (such as chemotherapy and immunotherapy).

Criteria:

• Stage IV NSCLC. Note that patients are eligible for the study if they have received definitive treatment for early stage disease, presuming that they remain candidates for local ablative therapy (LAT).
• Has had up to four cycles of standard first-line systemic therapy+/- 3 weeks, defined as
  1. platinum-doublet chemotherapy,
  2. ICI, or 
  3. platinum-doublet chemotherapy + ICI at the baseline ctDNA draw being used for the study.
• Detectable ctDNA at baseline ctDNA blood draw.
• Ten or less metastatic lesions (Note that this criterion includes lesions, not sites: 3 brain
  metastases = 3 lesions)
• Age ≥ 18 years

Locations: Hartford Hospital, Hartford HealthCare Cancer Institute at The Hospital of Central Connecticut

Contacts: Hartford Region: Christopher.Sampson@hhchealth.org (860) 972-5026, Hayley.Dunnack@hhchealth.org (860) 972-5518; Central Region: Siobhan.Reilly@hhchealth.org (860) 696-4958

Sponsor: Memorial Sloan Kettering