This open-label, prospective, single-arm Phase II trial explores whether adding stereotactic body radiotherapy (SBRT) or hypofractionated radiotherapy to oligoprogressive lesions can help delay disease progression in patients with metastatic melanoma. Participants may have up to ten extracranial oligoprogressive sites, with no upper limit on the total number of metastatic lesions. The study aims to assess whether targeting these progressing sites with focused radiotherapy can extend progression-free survival in this patient population.
This study evaluates the use of stereotactic body radiotherapy (SBRT) or hypofractionated radiotherapy in patients with metastatic melanoma who have up to 10 extracranial oligoprogressive lesions while receiving first-line systemic therapy. Oligoprogression refers to progression at a limited number of sites, while the remaining disease remains controlled by systemic treatment. Participants will continue their current systemic therapy and receive SBRT or hypofractionated radiotherapy to all oligoprogressive lesions. The study will assess whether this approach can delay overall disease progression and extend the duration of benefit from ongoing systemic therapy. Imaging will be used to monitor disease progression, and blood samples will be collected at baseline, after radiation, and at disease progression for exploratory analysis. Additional outcomes include overall survival, time on current therapy, toxicity, quality of life, and out-of-field response.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
52
SBRT will be delivered as per institutional standard.
University Health Network
Toronto, Ontario, Canada
RECRUITINGProgression-Free Survival (PFS) assessed by radiological imaging using RECIST v1.1 criteria
To determine if the addition of SBRT or hypofractionated radiation to progressive lesions improves progression-free survival in patients with metastatic melanoma. Radiological progression will be evaluated using CT, PET-CT, or MRI according to RECIST v1.1.
Time frame: From enrollment up to 24 months
Overall Survival (OS) measured from date of enrollment to death from any cause
Time frame: Enrollment up to 24 months
Time on Current Systemic Therapy After Initial Oligoprogression
Time frame: From enrollment up to 24 months
Out-of-field response assessed by radiological imaging (CT, PET-CT, or MRI)
Time frame: From enrollment up to 24 months.
Reporting acute and late toxicities of SBRT
Time frame: Enrollment up to 24 months
Participant-reported adverse events measured using PRO-CTCAE questionnaire
Time frame: From baseline through follow-up (up to 24 months)
Participant-reported quality of life measured using EORTC QLQ-C30 questionnaire
Time frame: From baseline through follow-up (up to 24 months)
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