Yonsei Cancer Hospital Expands Heavy Ion Therapy to Stage IV Oligometastatic Lung Cancer

Expansion from Early-Stage Lung Cancer to Broader Applications
Potential for Improved Survival through Combined Systemic and Local Therapies

Yonsei Cancer Center's heavy ion therapy program, operated by Yonsei Cancer Center, is expanding its treatment indications beyond early-stage lung cancer to include stage IV oligometastatic lung cancer cases with limited metastatic lesions.

On September 7, Yonsei Cancer Center announced plans to extend heavy ion therapy—previously focused primarily on early-stage non-small cell lung cancer—to patients with stage IV oligometastatic lung cancer. While lung cancer that has metastasized to other organs is generally classified as stage IV, treatment strategies can differ depending on the extent of metastasis. Widespread metastasis across multiple organs calls for a different approach compared to oligometastatic lung cancer, in which metastatic lesions are limited to specific areas.

Recent studies have shown that for patients with oligometastatic lung cancer, combining systemic treatment—such as chemotherapy or targeted therapies—with local therapy to eliminate both the primary tumor and metastatic lesions through radiation therapy can extend overall survival.

The effectiveness of this combined strategy, particularly for oligometastatic lung cancer with EGFR gene mutations, has been demonstrated. In an international multicenter phase III clinical trial, the progression-free survival of patients receiving an EGFR-targeted therapy plus radiation treatment for both the primary and metastatic tumors increased from 12.5 months to 20.2 months, while overall survival extended from 17.4 months to 25.5 months.

Professor Kyunghwan Kim at Yonsei Cancer Center's Heavy Ion Therapy Center preparing for heavy ion therapy. Yonsei Cancer Center

Another phase III clinical trial found that the combined use of targeted therapy and thoracic radiation therapy increased progression-free survival from 10.6 months to 17.1 months, and extended overall survival from 26.2 months to 34.4 months. The risk of disease progression was reduced by 43%, and the risk of death decreased by 38%.

In Korea, Yonsei Cancer Center has also confirmed the potential of such a treatment strategy through a multicenter phase II study. Among patients with oligometastatic lung cancer harboring EGFR mutations, concurrent use of the third-generation targeted therapy lazertinib and stereotactic body radiation therapy focused on tumor lesions resulted in a median progression-free survival of 34 months. Severe radiation pneumonitis of grade 3 or higher did not occur.

Based on these research results, Yonsei Cancer Center plans to utilize heavy ion therapy as a new local treatment option for oligometastatic lung cancer.

Heavy ion therapy will particularly be offered to elderly patients and those with compromised pulmonary function, who often face limitations or high risk with conventional radiation therapy. For patients with comorbidities like interstitial lung disease or idiopathic pulmonary fibrosis, radiation therapy carries a risk of radiation pneumonitis or aggravation of pre-existing lung conditions, making aggressive treatment challenging.

Heavy ion therapy allows concentrated delivery of radiation to cancer cells, while minimizing exposure to surrounding healthy tissue. This approach reduces not only damage to normal lung tissue but also limits radiation exposure to neighboring organs such as the heart and esophagus.

Professor Kim Kyunghwan, Department of Radiation Oncology at Yonsei Cancer Center, stated, "The Heavy Ion Therapy Center at Yonsei Cancer Center will first expand the application of heavy ion therapy primarily to patients with oligometastatic lung cancer who have excellent responses to systemic treatment, such as those with EGFR mutations, and who can expect long-term survival. We will continue to accumulate clinical data for these patients to further define the effectiveness and role of heavy ion therapy in stage IV lung cancer."

Kim Hyeryeon, head of the Lung Cancer Center, commented, "Even among patients with stage IV lung cancer, those with limited metastases and good performance status may achieve long-term survival through aggressive local therapies. By organically integrating surgery, chemotherapy, targeted therapy, radiation therapy, and now heavy ion therapy, we will continue to present optimal, individualized treatment strategies for each patient."

This content was produced with the assistance of AI translation services.