LATEST NEWS: 22 June 2026

In an important step toward improving outcomes for people with advanced lung cancer, TROG is set to launch a new international trial testing a novel radiation therapy approach for Australia’s deadliest cancer.

The TROG 21.10/TOGA 20-005 PRIME-Lung (Primary Radiotherapy in Metastatic Lung) trial, which will begin recruiting patients in the coming months, will investigate whether adding radiation therapy to standard systemic treatment early after diagnosis of metastatic non-small cell lung cancer (NSCLC) improves overall survival.

It is thought that giving early, highly targeted radiation therapy might reduce the risk of further metastatic spread of the cancer, thereby improving survival outcomes.

TROG is the primary sponsor of the phase III registry-based trial, which is being conducted in collaboration with the Thoracic Oncology Group Australasia (TOGA), the Canadian Pulmonary Radiation Investigators (CAPRI), the Irish Cancer Trials Group (ICTG) and Peter MacCallum Cancer Centre/AURORA registry database.

The trial, which received a $1.5 million Medical Research Future Fund grant, will enrol 420 patients with advanced lung cancer.

A total of 15 Australian sites will be involved, with Peter MacCallum Cancer Centre in Melbourne and Icon Cancer Centre, Gold Coast, already confirmed. A further 10 trial sites in Ireland and Canada will be added later this year.

Participants will be randomised to receive either standard of care (systematic chemotherapy and immunotherapy) or standard of care plus radiation therapy to the primary tumour in the lung.

Cancer Australia data shows that an estimated 9000 Australians died from lung cancer in 2025, accounting for 17% of all deaths from cancer. The chance of surviving at least five years after diagnosis remains poor, at 27%.

Trial Chief Investigator Prof Shankar Siva, from Peter MacCallum Cancer Centre, said there was an urgent need to improve lung cancer outcomes, which were particularly poor once the cancer had spread.

Similar interventions had shown overall survival benefits in specifically mutated lung cancer, breast, prostate and nasopharyngeal cancer trials. Chest radiation therapy is already used as standard of care for symptom control in advanced lung cancer, Prof Siva said.

The trial will build on a PRIME-Lung pilot study involving 40 patients, which demonstrated that the intervention was safe and well-tolerated.

Prof Siva  said it was exciting to be launching the new trial in Australia with involvement of the international cancer community, ensuring the results had the potential to impact lung cancer management globally.

“Current treatment strategies in advanced lung cancer rely on drug treatments, however, patients inevitably develop resistance to treatment, so we need to explore alternatives,”  he said. “We aim to show that when we eradicate the primary tumour with radiotherapy, we also enhance the impact of drug treatments and can prevent the further spread of cancer to other sites in the body.”

Read more about the trial