TRIAL UPDATE: 15 July 2025

The TROG 20.01 CHEST-RT trial is set to add to the evidence about whether radiation therapy could be a safe and useful addition in the management of an aggressive form of lung cancer, as outlined in a newly published paper.

Congratulations to trial chairs Dr Eric Hau, from Westmead Hospital in NSW, and Dr Sagun Parakh, from Austin Hospital in Victoria, and the research team on the publication of the TROG 20.01 CHEST RT trial protocol paper in BMJ Open.

CHEST RT is investigating the addition of thoracic radiation therapy to chemotherapy and immunotherapy treatment for patients with extensive stage small-cell lung cancer (ES-SCLC).

SCLC accounts for approximately 15% of all lung cancer cases,  with the majority of those patients diagnosed with extensive stage disease, which has poor five-year survival rate of less than 7%.

For over 20 years, a combination of chemotherapy (using the drugs etoposide with either cisplatin or carboplatin) had been used to treat ES-SCLC. Adding immunotherapy to the chemotherapy combination has been shown to improve response to treatment, and the combination of therapies is now the standard treatment.

However, research has shown that radiation therapy can also improve the ability of the body’s immune system to recognise tumours.

In the CHEST RT trial, researchers are investigating whether adding thoracic radiation therapy to the standard chemo/immunotherapy treatment could further improve outcomes for patients with this aggressive form of lung cancer.

TROG Cancer Research is the primary sponsor and co-ordinator of the trial, which is funded by AstraZeneca. TROG is also conducting radiation therapy quality assurance and central imaging data collection and storage for the trial.

The protocol paper outlines how the trial – a single-arm, open-label, prospective, multicentre phase II trial study – aims to establish the primary endpoints of safety and feasibility of combining thoracic radiation therapy with chemotherapy and immunotherapy in patients with ES-SCLC.

Patient survival and responses to treatment will be assessed as secondary endpoints of the study.

The trial closed to recruitment in August 2024 ahead of schedule, with 35 participants enrolled across sites in NSW, Victoria and Queensland. It is anticipated the last participant will finish follow-up in September 2027.

“There is limited evidence regarding the safety and efficacy of radiotherapy for ES-SCLC, in the era of immunotherapy,” the researchers write in the paper. “Through this study, we aim to demonstrate the safety and feasibility of combining radiotherapy with standard of care chemoimmunotherapy, aimed at reducing local recurrence and improving on current responses with chemoimmunotherapy alone.”

• Read the paper in BMJ Open
• Find out more about TROG 20.01CHEST-RT trial.