OncoMatch

OncoMatch/Clinical Trials/NCT06500481

Testing Proton Craniospinal Radiation Therapy Versus the Usual Radiation Therapy for Leptomeningeal Metastasis, RADIATE-LM Trial

Is NCT06500481 recruiting? Yes, currently enrolling (May 2026). This Phase 3 trial studies non-drug interventions for anatomic stage iv breast cancer ajcc v8.

Phase 3RecruitingNRG OncologyNCT06500481Data as of May 2026

This phase III trial compares proton craniospinal irradiation (pCSI) to involved-field radiation therapy (IFRT) for the treatment of breast or non-small cell lung cancer that has spread from where it first started to the cerebrospinal fluid filled space that surrounds the brain and spinal cord (leptomeningeal metastasis). Patients with leptomeningeal metastasis (LM) may develop multiple areas of nervous system (neurologic) impairment that can be life-threatening. Radiation therapy (RT) effectively relieves local symptoms due to LM. RT uses high energy radiography (x-rays), particles, or radioactive seeds to kill cancer cells and shrink tumors. IFRT is commonly used to treat symptoms of LM. IFRT is radiation treatment that uses x-rays to treat specific areas of LM and to relieve and/or prevent symptoms. pCSI uses protons that can be directed with more accuracy than x-rays which allows treatment of the entire central nervous system space containing the cerebrospinal fluid (CSF), brain, and spinal cord. The pCSI treatment could delay the worsening of LM. Giving pCSI may be better than IFRT in treating LM in patients with breast or non-small cell lung cancer.

Check if I qualify

Extracted eligibility criteria

Cancer type

Breast Carcinoma

Non-Small Cell Lung Carcinoma

Tumor Agnostic

Disease stage

Required: Stage IV (AJCC v8)

Metastatic disease required

Anatomic Stage IV Breast Cancer AJCC v8; Stage IV Lung Cancer AJCC v8

Prior therapy

Cannot have received: radiation therapy to the spinal cord with EQD2 > 40Gy or cauda equina with EQD2 > 50Gy

No prior radiation therapy to the spinal cord with equivalent dose in 2 gray (Gy) fractions (EQD2) more than 40Gy or cauda equina with EQD2 more than 50Gy using alpha/beta ratio of 3

Cannot have received: treatment for leptomeningeal metastasis

Exception: prior CNS treatment for other non-leptomeningeal disease is allowed

No prior treatment for leptomeningeal metastasis (note: prior CNS treatment for other non-leptomeningeal disease is allowed)

Lab requirements

Blood counts

Hemoglobin  8.0 g/dl (transfusion/intervention allowed); ANC  1,000/mm^3 (G-CSF/intervention allowed); Platelets  100,000/mm^3 (transfusion/intervention allowed)

Liver function

Total bilirubin  1.5 0 institutional upper limit of normal (ULN) (patients with known Gilbert disease without other clinically significant liver abnormalities are not excluded); AST and ALT  3 0 ULN

Hemoglobin  8.0 g/dl ... ANC  1,000/mm^3 ... Platelets  100,000/mm^3 ... Total bilirubin  1.5 0 ULN ... AST and ALT  3 0 ULN

Structured fields extracted by AI. May contain errors — verify against the official protocol.

US trial sites

  • University of Arkansas for Medical Sciences · Little Rock, Arkansas
  • UC San Diego Health System - Encinitas · Encinitas, California
  • UC San Diego Moores Cancer Center · La Jolla, California
  • UC San Diego Medical Center - Hillcrest · San Diego, California
  • California Protons Cancer Therapy Center · San Diego, California

Showing up to 5 US sites. See all sites on ClinicalTrials.gov →

Could you qualify for this trial?

Enter your biomarker results to see how this trial's eligibility criteria match your specific cancer profile.

Check if I qualify