Mehta on the Phase 3 METIS Trial of TTFields for Brain Metastases in NSCLC

The phase 3 METIS trial investigated the use of tumor treating fields (TTFields) therapy following stereotactic radiosurgery (SRS) in patients with non-small cell lung cancer (NSCLC) and brain metastases. The study found that TTFields therapy significantly extended the time to further brain tumor progression compared to SRS alone. Additionally, TTFields did not worsen quality of life or cognitive function. These findings suggest that TTFields therapy could be a valuable treatment option for NSCLC patients with brain metastases, potentially delaying the need for whole brain radiotherapy.

Here, Minesh Mehta, MD, chief of radiation oncology and deputy director at Miami Cancer Institute, part of Baptist Health South Florida, discusses the methodology and findings from the trial presented at the 2024 ASCO Annual Meeting.

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0:05 | So approximately 100 to 300,000 patients develop brain metastasis every year. The vast majority of these patients are treated with a technique called stereotactic radiosurgery, which is very effective at treating the lesions that are in the brain. But unfortunately, these patients continually relapse again and again in the brain. Treating these relapses in the brain lack of controlling the disease in the brain is the major unmet need in this population.

0:29 | So this particular trial, known as METIS, or EF25, is an international multicenter phase 3 randomized trial, which looked at the addition of a treatment called tumor treating fields to standard of care therapy in patients with non-small cell lung cancer with brain metastases without actionable mutations.

0:48 | So the topline results from the trial looked at intracranial progression. Time to intracranial progression was significantly lengthened in favor of tumor treating fields therapy. In the control arm, the time the median time was 10.3 months in the experimental arm, it was lengthened to 21.9 months.