Lung cancer trial: can radiation boost targeted drugs for limited metastases?

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

Inclusion Criteria: 1. Patients with pathologically proven diagnosis of NSCLC 2. Patients with positive oncogene driver mutation (EGFR or ALK/ROS) 3. Patients who have received at least 2-4 months of TKI therapy without progression 4. Patients with 1-5 sites of metastatic disease not including the primary tumor and regional nodes (less than 3 metastatic lesions in one organ will be eligible and 4 or more metastatic lesions in one organ will be ineligible) 5. Patients suitable for local consolidative therapy 6. Adequate end-organ function CBC/differential obtained within 15 days prior to registration on study, with adequate bone marrow function defined as follows: * Absolute neutrophil count (ANC) ≥ 500 cells/mm3; * Platelets ≥ 50,000 cells/mm3; * Hemoglobin ≥ 8.0 g/dl (Use of transfusion or other intervention to achieve Hgb ≥ 8.0 g/dl is acceptable); 7. Patients with ECOG performance status of 0-2 8. Age \> 18 years 9. For females of child-bearing potential, negative serum or urine pregnancy test within 14 days prior to study registration Exclusion Criteria: 1. Patients with progressive disease after 2-3 months of initial TKI therapy 2. Patients with negative oncogene driver mutations (EGFR/ALK/ROS) 3. Patients not suitable for local consolidative radiation therapy 4. Patients who are not suitable for further continuation of TKI therapy due to toxicity 5. Severe, active co-morbidity defined as follows: * Unstable angina and/or congestive heart failure requiring hospitalization within the last 6 months; * Transmural myocardial infarction within the last 6 months; * Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration; 6. Patients with prior history of radiation therapy to thorax 7. Patients with second malignancy (Synchronous or Metachronous) 8. Pregnancy