Recruiting

Ablative Radiotherapy

Sponsor:

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

Code:

NCT05508464

Conditions

Metastatic Cancer

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Arm 2: SABR

Arm 1: Standard of Care

Study Details

Brief summary:

This is a phase II/III international multicentre randomized trial. Patients will be randomized in a 1:2 ratio between the standard of care (Arm 1) and SABR (Arm 2) to all sites of disease. The study will start as a phase II trial with an opportunity to convert to a phase III trial. The objective of this trial is to determine the impact of SABR on overall survival, progression-free survival, quality of life, and toxicity in patients with polymetastatic disease.

Conditions

Metastatic Cancer

Study ID

NCT05508464

Start date

Oct 16, 2023

Status verified date

Mar, 2026

Completion date

Jan 1, 2034

Anticipated

Primary completion date

Jan 1, 2034

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Age 18 or older
  • willing and able to provide informed consent
  • ECOG performance status 0-2
  • Life expectancy > or equal to 6 months
  • Histologically confirmed malignancy with evidence of metastatic disease on imaging
  • All sites of disease can be safely treated on a preliminary radiation plan
  • > or equal to 11 metastases (the primary tumor does not have to be controlled and can be included as a target if it can feasibly and safely be treated with SABR. If the primary tumor is treated, a minimum of 12 targets are required0 at least 11 metastases are required in addition to the primary tumor.)
  • Investigations required within 12 weeks of enrollment:
  • Brain: MRI is required for all patients with known untreated or previously treated brain metastases. MRI is strongly recommended for all tumor sites with a propensity to develop brian metastases.
  • Body: 18-FDG PET/CT imaging is recommended, except for tumors where FDG uptake is not expected (e.g. prostate, renal cell carcinoma). PSMA-PET or choline-PET is recommended for prostate cancer. In situations where a PET scan is unavailable, or for tumors that do not take up radiotracer, a CT neck/chest/abdomen/pelvis and bone scan are required.
  • Liver: For patients with liver metastases, a diagnostic or simulation MRI is required to confirm the total number of metastases.
  • No plans for systemic therapy (i.e. chemotherapy, targeted agent, immunotherapy) for 3 months from the time of enrolment. Reasons may include: a break from systemic therapy is desired by the patient and medical oncologist, the patient declines next line of systemic therapy, or no further systemic therapy options are available. Exceptions include hormone therapy for breast cancer or prostate cancer, which may be continued.
  • SABR or palliative radiotherapy should commence no later than 2 weeks after randomization.
  • For patients with brain metastases that are going to be treated regardless of the study arm, there must be additional extracranial disease present that will be treated with SABR on Arm 2 and not treated with SABR on Arm 1.

Exclusion Criteria:

  • Serious medical comorbidities precluding radiotherapy. These include interstitial lung disease in patients requiring thoracic radiation, Chrohn's disease in patients where the GI tract will receive radiotherapy, ulcerative colitis where the bowel will receive radiotherapy and connective tissue disorders such as lupus or scleroderma.
  • For patients with liver metastases, moderate/severe liver dysfunction (Child-Pugh B or C)
  • Substantial overlap with a previously treated radiation volume. Prior radiotherapy is allowed, as long as the composite plan meets dose constraints herein. For patients treated with radiation previously, biologically effective dose calculations should be used to equate previous doses to the tolerance doses listed in Appendix 1. All such cases must be discussed with the study PI.
  • Inability to treat all sites of disease. Any brain metastasis >3 cm in size or a total volume of brain metastases greater than 30 cc.
  • Solitary or dominant brian metastasis requiring surgical decompression.
  • Radiologic evidence of spinal cord compression.
  • Disseminated disease, including leptomeningeal metastases, peritoneal metastases/carcinomatosis, malignant pleural effusion, and lymphangitis carcinomatosis.
  • Pregnant or lactating women.

Study Design

Enrollment

138 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

active comparator: Standard of Care

Standard or care palliative radiotherapy (includes the option for no treatment)

active comparator: SABR

SABR to all tumors 6Gy x 5 over 3 weeks

Interventions

Arm 2: SABR

SABR to all tumors 6 Gy x 5 over three weeks

Arm 1: Standard of Care

Standard of care palliative radiotherapy

Primary outcome measure

  • Overall Survival [ Time Frame: Time from randomization to death from any cause, patients followed for 5 years ]

Central Contacts and Locations

Central contacts

Timothy Nguyen, M.D.

519-685-8500Timothy.Nguyen@lhsc.on.ca

Locations

London Health Sciences Centre- London Regional Cancer Program

Recruiting

London, Ontario, Canada, N6A 5W9

Contacts

Timothy Nguyen, M.D

519-685-8500Timothy.Nguyen@lhsc.on.ca

Centre Hospitalier de L'Universite de Montreal (CHUM)

Recruiting

Montreal, Quebec, Canada, H2X 3E4

Contacts

Eva-Sabrina Nkurunziza

514-890-8000eva-sabrina.nkurunziza.chum@ssss.gouv.qc.ca

Principal Investigator:

Houda Bahig, MD

More Information

Sponsor

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

Last update posted

Jun 29, 2026

Last verified

Mar, 2026

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's on 2026-06-29.