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08 Sep 2021

Win-win for patients and clinicians as CCI breaks new ground for pulmonary oligometastases treatment

  • VCCC Alliance
  • Centre for Cancer Immunotherapy

Latest achievement for the innovative collaboration 

A groundbreaking study emerging from the Centre for Cancer Immunotherapy (CCI) – a joint initiative between the Peter MacCallum Cancer Centre, the University of Melbourne and the VCCC Alliance – has become the latest achievement for the innovative collaboration.

Single dose or multi-fraction?

SAFRON II, led by Peter MacCallum Cancer Centre’s Associate Professor Shankar Siva and funded through the VCCC Alliance, addresses a previously unresolved question around the most efficient way to deliver Stereotactic Ablative Radiotherapy (SABR) to patients with low volume metastatic (oligometastatic) pulmonary disease.

A lack of evidence from randomised clinical trials to guide the optimal approach for SABR in patients with pulmonary oligometastases was the genesis for the work, as Dr Siva and his team set out to discover whether a single dose or multiple smaller doses of SABR is a more effective treatment method to reduce volume of cancer.

After conducting a phase 2 randomised clinical trial of 90 patients across 13 centres in Australia and New Zealand with patients with one to three lung oligometastases, the findings showed that a single dose of SABR treatment has the same clinical outcomes (tumour control and toxicity) as multiple smaller fractions of SABR.

More convenient, efficient treatment

Senior author on the paper, Associate Professor Paul Neeson said the findings from SAFRON II represented a significant win-win for both patients and clinicians.

“This is the first randomised clinical trial in patients with lung metastases to show that that SABR treatment is safe, effective and the patients had longer-term survival,” he said.

“In addition, rather than multiple scheduled visits, our study indicates that a patient only has to visit the cancer centre once for effective treatment of oligometastatic disease. This makes this innovation in radiation treatment delivery more convenient for the patient, and it consumes fewer resources and less time in the cancer centre.”

Implications for immunology

As well as the clear benefits to patients, SAFRON II also has significant implications for immunotherapy research; it is the first study to show that following radiation treatment of lung metastases, changes in systemic immunity occurred and this was associated with a better clinical outcome.

Aspects of those systemic immune changes suggest that this single high dose SABR treatment would combine well with immune-base therapies, particularly those which release the brakes on the immune system, or immune checkpoint blockade.

Centre for Cancer Immunotherapy delivers

Financial support from the VCCC Alliance through the Strategic Research Plan’s Immunotherapy program enabled the CCI team to use state-of-the-art technology in collaboration with SAFRON II clinical trial lead Dr Siva.

The collaborative structure of the CCI brings together clinicians and researchers with a driving focus on accelerating both the discovery and clinical translation aspects of research.

Reflecting on the rapid development of the CCI – still in its infancy in laboratory terms – Dr Neeson was enthusiastic about its potential to continue producing cutting-edge research.

“The Centre for Cancer Immunotherapy is now delivering high impact studies just 18 months after launching.”

“It comprises scientists and clinician-scientists with extensive experience in the technical and academic aspects of human cancer immunology and immunotherapy. These unique skills lead to high-impact collaborative studies and translation to the clinic for better care of cancer patients.”

The SAFRON II findings were published in JAMA Oncology on 29 August, 2021. View the full paper here.