Study on Using Radiotherapy to Prevent Cancer Growth in Metastatic Non-Small-Cell Lung Cancer

Inclusion Criteria

• Have stage IV metastatic non-small cell lung cancer (NSCLC) confirmed by imaging and lab tests, without specific mutations that can be targeted by drugs.
• Cancer must have shown limited progression after at least three cycles of initial treatment with immune checkpoint inhibitors (ICI) alone or combined with chemotherapy.
• All sites of limited cancer progression can be safely treated with specialized radiotherapy, as determined by a radiation oncologist.
• Patients with treated, stable brain metastases that are not causing symptoms and do not require steroids are eligible.
• Eligible for standard second-line systemic therapy if assigned to the second treatment group.
• Must be 18 years or older.
• Have a performance status score of 0, 1, or 2, indicating full activity or some restriction in strenuous activities.
• If previously treated with systemic therapy, at least six months must have passed since the last treatment.
• Must have recovered from any side effects of previous treatments to a mild level.
• Previous surgery or radiation for NSCLC is allowed if certain conditions are met.
• Must be able to start specialized radiotherapy within three weeks of joining the study.
• Must be able to complete quality of life questionnaires in English, French, or Spanish.
• Must be available for treatment and follow-up appointments.
• Participants of childbearing potential must agree to use effective contraception.

Exclusion Criteria

• Have large-cell neuroendocrine carcinoma, pulmonary carcinoid tumor, or mixed small cell and non-small cell lung cancer.
• Have leptomeningeal disease (cancer spread to the membranes around the brain and spinal cord).
• Be pregnant.
• Have serious medical conditions that make radiotherapy unsafe, such as certain lung or liver diseases.
• Have any condition that the study doctor believes makes participation inappropriate.
• Not currently receiving immune checkpoint inhibitors or chemotherapy.
• Have another cancer that could interfere with the study treatment.
• Taking medications that could interact with the study treatment.
• Receiving other cancer treatments or investigational drugs.
• Have received a live vaccine within 30 days before joining the study.