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HealthQuiet 9d · day 11

MAVERICK trial shows MRI surveillance alone beats radiation in small-cell lung cancer

Phase 3 study finds skipping preventive brain radiation reduces cognitive decline risk by 40% in SCLC patients monitored with MRI.

newest coverage 9d agosummary written 9d ago9 pieces Google NewsNewswires

What to know

  • MRI surveillance alone reduced cognitive failure or death risk by 40% compared to MRI plus preventive brain radiation in 304 SCLC patients, with patients skipping radiation showing better cognition preservation at 12 months (17% vs 6% failure-free survival).
  • Patients avoiding radiation also experienced fewer side effects including fatigue, hair loss, nausea, and appetite loss, challenging the standard of care that has combined MRI with prophylactic cranial irradiation (PCI).
  • Preliminary overall survival analysis at 128 deaths showed no difference between arms (HR 0.90), though final analysis awaits 190 events; radiation reduced brain metastases detection but did not improve progression-free survival.
  • Expert commentary suggests the findings support MRI surveillance as standard for extensive-stage SCLC immediately, but recommends awaiting final OS data and results from the competing PRIMALung trial before changing practice for potentially curable limited-stage disease.

“Brain MRI surveillance may allow for earlier detection of brain metastases and more effective salvage therapy, and thus potentially eliminate the overall survival benefit previously observed with PCI”

Chad Rusthoven, MD, Principal investigator · MedPage Today ↗

Chad Rusthoven, MD Principal investigator, University of ColoradoHideyuki Harada, MD, PhD Invited discussant, Shizuoka Cancer Center

MAVERICK trial shows MRI surveillance alone beats radiation in small-cell lung cancer
MedPage Today

How it unfolded 2 developments, newest first · click a bar or a number to jump articles

Peak 3 pieces in 3h at Sep 14, 12 AM; 9 pieces over 11 days (9 articles) Sep 12, 9 PM — 1 piece · 1 article — Google News 1Sep 13, 12 AM — quietSep 13, 3 AM — quietSep 13, 6 AM — quietSep 13, 9 AM — quietSep 13, 12 PM — quietSep 13, 3 PM — quietSep 13, 6 PM — quietSep 13, 9 PM — quietSep 14, 12 AM — 3 pieces · 3 articles — Google News 3Sep 14, 3 AM — quietSep 14, 6 AM — quietSep 14, 9 AM — 1 piece · 1 article — Newswires 1Sep 14, 12 PM — 1 piece · 1 article — Newswires 1Sep 14, 3 PM — 1 piece · 1 article — Google News 1Sep 14, 6 PM — quietSep 14, 9 PM — quietSep 15, 12 AM — 2 pieces · 2 articles — Google News 2Sep 15, 3 AM — quietSep 15, 6 AM — quietSep 15, 9 AM — quietSep 15, 12 PM — quietSep 15, 3 PM — quietSep 15, 6 PM — quietSep 15, 9 PM — quietSep 16, 12 AM — quietSep 16, 3 AM — quietSep 16, 6 AM — quietSep 16, 9 AM — quietSep 16, 12 PM — quietSep 16, 3 PM — quietSep 16, 6 PM — quietSep 16, 9 PM — quietSep 17, 12 AM — quietSep 17, 3 AM — quietSep 17, 6 AM — quietSep 17, 9 AM — quietSep 17, 12 PM — quietSep 17, 3 PM — quietSep 17, 6 PM — quietSep 17, 9 PM — quietSep 18, 12 AM — quietSep 18, 3 AM — quietSep 18, 6 AM — quietSep 18, 9 AM — quietSep 18, 12 PM — quietSep 18, 3 PM — quietSep 18, 6 PM — quietSep 18, 9 PM — quietSep 19, 12 AM — quietSep 19, 3 AM — quietSep 19, 6 AM — quietSep 19, 9 AM — quietSep 19, 12 PM — quietSep 19, 3 PM — quietSep 19, 6 PM — quietSep 19, 9 PM — quietSep 20, 12 AM — quietSep 20, 3 AM — quietSep 20, 6 AM — quietSep 20, 9 AM — quietSep 20, 12 PM — quietSep 20, 3 PM — quietSep 20, 6 PM — quietSep 20, 9 PM — quietSep 21, 12 AM — quietSep 21, 3 AM — quietSep 21, 6 AM — quietSep 21, 9 AM — quietSep 21, 12 PM — quietSep 21, 3 PM — quietSep 21, 6 PM — quietSep 21, 9 PM — quietSep 22, 12 AM — quietSep 22, 3 AM — quietSep 22, 6 AM — quietSep 22, 9 AM — quietSep 22, 12 PM — quietSep 22, 3 PM — quietSep 22, 6 PM — quietSep 22, 9 PM — quietYesterday, 12 AM — quietYesterday, 3 AM — quietYesterday, 6 AM — quietYesterday, 9 AM — quietYesterday, 12 PM — quietYesterday, 3 PM — quietYesterday, 6 PM — quietYesterday, 9 PM — quietToday, 12 AM — quietToday, 3 AM — quietToday, 6 AM — quiet 12
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  1. 2

    Expert cautions that limited-stage SCLC decisions should await final overall survival data

    Invited discussant Hideyuki Harada from Japan's Shizuoka Cancer Center notes the MAVERICK results support MRI surveillance as standard for extensive-stage SCLC, but advises waiting for final overall survival analysis and results from the PRIMALung trial before definitively changing practice for limited-stage disease, which is potentially curable.

    “for extensive-stage small cell lung cancer, based on the results from MAVERICK and previous phase III trials, MRI surveillance can be considered the standard of care in the MRI era.”
    — Hideyuki Harada, MD, PhD
    1. 2 outlets Brain MRI Surveillance Alone Helps Preserve Cognition in Small Cell Lung Cancer

      first by MedPage Today, 9d ago · also News-Medical

      2 more headlines
  2. background

    Preliminary overall survival analysis shows no difference between treatment arms — At 128 deaths, the OS analysis found no significant difference between MRI-alone and MRI-plus-PCI groups (HR 0.90, 90% CI 0.67-1.20), with final analysis planned after 190 events. Patients receiving PCI were less likely to develop brain metastases at 12 months (15% vs 30%), but progression-free survival was similar between groups (9.2 vs 10.2 months).

  3. 1

    MAVERICK trial results show MRI surveillance alone superior to MRI plus radiation

    At the World Conference on Lung Cancer in Seoul, Chad Rusthoven presents findings showing MRI surveillance alone reduced cognitive failure or death risk by 40% (hazard ratio 0.60, P=0.0005) with 12-month cognitive failure-free survival of 17% versus 6% with PCI. Patients skipping radiotherapy also experienced significant reductions in fatigue, alopecia, nausea, and poor appetite.

    “Overall, these results support MRI surveillance as the preferred management approach for patients with small-cell lung cancer…”
    — Chad Rusthoven, MD
    1. 2 outlets Brain MRI Surveillance Alone May Be Enough in SCLC

      first by Medscape, 9d ago · also Google News · Health

      1 more headline
    2. 2 outlets Trial supports MRI surveillance over preventive brain radiation in small-cell lung cancer

      first by Medical Xpress, 11d ago · also Yahoo! Finance Canada

      2 more headlines
  4. background

    MAVERICK trial enrollment closes after five years — Study recruitment concludes with 304 patients across 139 institutions worldwide.

  5. background

    MAVERICK trial enrolls first patients at 139 global institutions — Researchers begin recruiting 304 small-cell lung cancer patients (68% limited-stage) who have completed initial therapy and have no brain metastases. Patients are randomized to either MRI surveillance alone or MRI surveillance plus prophylactic cranial irradiation (25 Gy in 10 fractions).