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Radiation Oncology • Palliation
How would you manage a patient with a high-risk asymptomatic bone metastasis with a driver mutation?
For example, if the patient had an ALK+ NSCLC initiating targeted therapy, would you offer prophylactic radiotherapy as per Gillespie et al., PMID 37748124, or first rely on targeted therapy, and only treat if the patient becomes symptomatic or failed to respond?
Answer from: Radiation Oncologist at Community Practice
It seems that the unexpected outcome of a survival benefit was likely due to the prevention of fractures that likely led to hospitalization then death. This was a phase II study and OS was a secondary outcome, but it does make sense. Complicating metastatic cancer with a femur fracture leading to ho...
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