Pioneering radiotherapy treatment emerging as a new option for cancers spread to lungs

Posted: 19 June 2023

A pioneering radiotherapy treatment developed at Peter Mac is emerging as a new treatment option for cancer that has spread to the lungs, following exciting results in a recent study.

Long-term survival data is now available from the SAFRON II clinical trial, which involved patients with up to three spots of cancer that had metastasized or spread from elsewhere to their lungs.

Patients in this Peter Mac-led trial received a type of high-dose and precisely targeted radiotherapy called SABR (Stereotactic Ablative Body Radiotherapy) to treat their cancers, instead of either surgery or ongoing drug therapy, which are standard alternatives. The long-term data shows that one-in-three had no active cancer at five years, enjoying many years of excellent quality of life without needing ongoing treatments.

Peter Mac patient John Higgins, 70, was diagnosed with lung cancer 12 years ago after two bouts of pneumonia and subsequently had his right lung removed. A few years later cancer emerged in the trachea that then spread into his left lung, which was successfully treated with SABR.

Having earlier experienced the side effects of chemotherapy, which caused kidney failure, Mr Higgins had little side effects with SABR. While his cancer in the trachea has since re-emerged, Mr Higgins has experienced great quality of life amongst other benefits.

“I had this nurse at Peter Mac and we’d sit and go over all these various questions about how I was feeling and what things I could do and couldn’t do, but there wasn’t much that I couldn’t do,” he said.

“I had no apprehensions at the SABR treatment because everything in the world of medical science moves so swiftly, so rapidly. But I also felt confident because of the people I was dealing with. The whole programme was explained to me in detail, and I felt a lot of confidence and I was more than happy to participate.

“I’m now 70 and was just turning 58 when I was diagnosed. At that time I just thought, well, you know, it happens. I’m in good hands and whatever will be will be. I consider it (cancer) one chapter in my life, it’s not the whole book.”

Peter Mac Associate Professor Shankar Siva presented the trial results at the European Society for Radiotherapy and Oncology conference in Vienna, Austria last month with a simultaneous publication of his paper in the Journal of Clinical Oncology. The report described the long-term outcomes of trial participants from 13 centres across Australia and New Zealand.

A/Prof Siva says the SAFRON II trial provides the most robust evidence to date for any metastasis-targeted cancer treatment in the lung.

“Compared to lifelong drug therapies, which is another standard alternative, SABR has little impact on quality of life. We found SABR to be approximately 10 times less costly, and can be delivered in as little as one to four visits of one hour each, without the need for ongoing cycles of therapy” he said.

“This trial shows exceptional long-term outcomes, and we believe this approach to treatment has great promise.”

The single fraction lung SABR treatment was initiated at Peter Mac and introduced nationwide over the last decade. A/Prof Siva has previously led the use of SABR to treat inoperable primary renal cell carcinoma.

Funded by Cancer Australia, this study was led from inception through to delivery by Peter Mac as the lead institution of this TranTasman Radiation Oncology Group trial across Australia and New Zealand.

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