Trial reportJournal of the National Cancer Institute2023
Randomized Trial of First-Line Tyrosine Kinase Inhibitor With or Without Radiotherapy for Synchronous Oligometastatic EGFR-Mutated Non-Small Cell Lung Cancer.
Trial report in Journal of the National Cancer Institute, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It has been retracted, and should not be counted. It is linked to 3 registered trials, which are not on this map. Cited by 153 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Tyrosine-kinase Inhibitor （TKI） With or Without SBRT in Newly Diagnosed EGFRm Advanced Staged Lung Adenocarcinoma
STereotactic Ablative RadioTherapy in NEWly Synchronous and mEtachRonous (Oligo-persistence, Oligo-induced, Oligo-progression) Oncogene and Non Oncogene Addicted OLIGO-metastatic Non-small Cell Lung Cancer Patients
Efficacy and Safety of Almonertinib Combined With Stereotactic Body Radiotherapy (SBRT) in the Treatment of Non-small Cell Lung Cancer With EGFR Sensitive Mutation: a Single-arm, Open-label Clinical Trial
Who cites it
153 citing papers in PubMed, 7 syntheses or guidelines pooled it, 235 citations in OpenAlex.
- Efficacy and safety of metastasis-directed therapy for oligometastatic cancer: a systematic review and meta-analysis of randomized controlled trials.Radiation oncology (London, England) · 2026Pooled it
- IPDMA - RADICAL - NSCLC: individual participant data meta-analysis and systematic review of radical local therapy for oligometastatic NSCLC.BMJ open respiratory research · 2025Pooled it
- Comparison of treatment regimens for unresectable stage III epidermal growth factor receptor ( EGFR ) mutant non-small cell lung cancer.Chinese medical journal · 2025Pooled it
- Efficacy and safety of tyrosine kinase inhibitors with thoracic radiotherapy for patients with oncogene-mutated non-small cell lung cancer: a meta-analysis.Radiation oncology (London, England) · 2024Pooled it
- Pooled it
- Health Economic Evaluation of Proton Therapy for Lung Cancer: A Systematic Review.International journal of environmental research and public health · 2023Pooled it
- Pooled it
- Phase 2 Trial of Consolidative Stereotactic Body Radiation Therapy in Patients With Metastatic Oncogene-driven Non-small Cell Lung Carcinoma Treated With Tyrosine Kinase Inhibitors.International journal of radiation oncology, biology, physics · 2025Trial
- [Standard-of-care systemic therapy with or without SBRT in patients with oligoprogressive breast cancer or NSCLC (CURB oligoprogression): an open-label, randomised, controlled, phase 2 study].Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Trial
- Addition of pulsed electric field ablation to SBRT for lung tumors: effect on health-related quality of life.Lung cancer management · 2026Article
- European lung cancer congress 2026 - the thoracic radiation oncologist's view.Clinical and translational radiation oncology · 2026Article
- Clinical outcomes of stereotactic body radiotherapy in oligometastatic disease: a national real-world cohort study.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
- Advances in radiotherapy-based multimodal treatment for non-small-cell lung cancer.Cancer pathogenesis and therapy · 2026Article
- Definitive radiotherapy for non-small-cell lung cancer: current practice and future directions.Japanese journal of radiology · 2026Review
- Impact of a Multidisciplinary Palliative Radiation Therapy Clinic on Patient Care.Advances in radiation oncology · 2026Article
- Targeting ClassicalCancers · 2026Review
- Early radiotherapy delays acquired gefitinib resistance in EGFR-mutant NSCLC by suppressing c-FOS-associated survival signaling.Respiratory research · 2026Article
- [European journal of nuclear medicine and molecular imaging · 2026Article
- Metastasectomy versus stereotactic body radiotherapy for lung metastases: a systematic review and meta-analysis of reconstructed time-to-event data on overall and progression-free survival.Journal of thoracic disease · 2026Article
- Article
93 more citing papers are in PubMed but not listed here.
Corrections and comments
- Expression of concern · 2022-04-01Concerns/Issues about Authorship/Affiliation · Concerns/Issues about Referencing/Attributions · Investigation by Journal/Publisher ·
- Commented on by
- Erratum issued
- Expression of concern
Authors and funding
31 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdding radiotherapy (RT) to systemic therapy improves progression-free survival (PFS) and overall survival (OS) in oligometastatic non-small cell lung cancer (NSCLC). Whether these findings translate to epidermal growth factor receptor (EGFR)-mutated NSCLC remains unknown. The SINDAS trial (NCT02893332) evaluated first-line tyrosine kinase inhibitor (TKI) therapy for EGFR-mutated synchronous oligometastatic NSCLC and randomized to upfront RT vs no RT; we now report the prespecified interim analysis at 68% accrual.
methodsInclusion criteria were biopsy-proven EGFR-mutated adenocarcinoma (per amplification refractory mutation system or next generation sequencing), with synchronous (newly diagnosed, treatment naïve) oligometastatic (≤5 metastases; ≤2 lesions in any one organ) NSCLC without brain metastases. All patients received a first-generation TKI (gefitinib, erlotinib, or icotinib), and randomization was between no RT vs RT (25-40 Gy in 5 fractions depending on tumor size and location) to all metastases and the primary tumor/involved regional lymphatics. The primary endpoint (intention to treat) was PFS. Secondary endpoints included OS and toxicities. All statistical tests were 2-sided.
resultsA total of 133 patients (n = 65 TKI only, n = 68 TKI with RT) were enrolled (2016-2019). The median follow-up was 23.6 months. The respective median PFS was 12.5 months vs 20.2 months (P < .001), and the median OS was 17.4 months vs 25.5 months (P < .001) for TKI only vs TKI with RT. Treatment yielded no grade 5 events and a 6% rate of symptomatic grade 3-4 pneumonitis in the TKI with RT arm. Based on the efficacy results of this prespecified interim analysis, the ethics committee recommended premature cessation of this trial.
conclusionsAs compared with a first-line TKI alone, addition of upfront local therapy using RT statistically significantly improved PFS and OS for EGFR-mutated NSCLC.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.