New combo therapy aims to control lung cancer spread in the chest

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Age ≥ 18 years. 2. Histologically or cytologically confirmed advanced lung adenocarcinoma. 3. Unlimited number of metastatic lesions, but with involvement of no more than 3 organs. 4. Previously untreated, clinical stage IV disease per AJCC/UICC 9th edition. 5. Presence of pleural effusion as indicated by chest CT or ultrasound; cytological confirmation of malignant cells in the pleural effusion is preferred. If malignant cells are not detected in the pleural effusion, chest CT with contrast or whole-body PET/CT must demonstrate unequivocal pleural nodular metastases. 6. After 8-10 weeks of furmonertinib therapy with or without therapeutic thoracentesis, the overall radiographic response is assessed as effective (CR + PR + SD), and malignant pleural effusion is adequately controlled (defined as no pleural effusion or only minimal pleural effusion on ultrasound or chest CT: maximum depth \< 3 cm, estimated volume \< 500 mL). Concurrent minimal pericardial effusion is permissible (defined as maximum diastolic width \< 1 cm on echocardiography, estimated volume \< 100 mL). 7. No prior thoracic radiotherapy. 8. Positive for EGFR-sensitive mutations (exon 19 deletion or exon 21 L858R). 9. No prior systemic anticancer therapy. 10. ECOG performance status 0-2, with a life expectancy of ≥ 12 weeks. 11. At least one measurable lesion per RECIST 1.1. 12. Adequate bone marrow function to tolerate anticancer treatment: WBC ≥ 3 × 10⁹/L, Hb ≥ 80 g/L, PLT ≥ 75 × 10⁹/L, and absolute neutrophil count (NEUT) ≥ 1.5 × 10⁹/L. 13. Essentially normal hepatic and renal function: 1. Serum creatinine ≤ 1.5 × upper limit of normal (ULN) or creatinine clearance (CrCl) ≥ 50 mL/min; 2. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN (≤ 5 × ULN is acceptable in patients with liver metastases); 3. Total bilirubin (TBIL) ≤ 1.5 × ULN; 4. Albumin ≥ 30 g/L and prealbumin ≥ 150 g/L. 14. Asymptomatic brain metastases. 15. Written informed consent obtained from all subjects. Exclusion Criteria: 1. Pre-existing interstitial lung disease (ILD) or infectious fever prior to treatment. 2. Radiographic progression (PD) after 8-10 weeks of TKI therapy, or development of grade ≥ 2 ILD. 3. Concurrent autoimmune disease requiring long-term oral corticosteroid therapy. 4. Severe anemia. 5. Known hypersensitivity to furmonertinib. 6. Significant respiratory symptoms (e.g., chest tightness, cough) that preclude tolerance to radiotherapy. 7. Active hepatitis B or C virus infection with concomitant grade \> 2 hepatic impairment. Patients may be considered eligible if liver function recovers to grade 1 after active hepatoprotective therapy and antiviral treatment. 8. Poorly controlled or continuously progressive pleural effusion after 8-10 weeks of furmonertinib therapy. 9. Symptomatic brain metastases.