A multicenter clinical trial found that implanting collagen tiles during brain surgery to deliver targeted radiation therapy dramatically improved tumor control, lowered the risk of recurrence and improved overall survival compared to current standard of care for patients with newly diagnosed brain metastases in need of surgical resection. The ROADS trial, co-led by Jeffrey Weinberg, M.D., professor of Neurosurgery; and Thomas Beckham, M.D., Ph.D., assistant professor of CNS Radiation Oncology, is the first randomized controlled Phase 3 trial comparing GammaTile cesium-131 collagen tile-based radiation therapy (TBRT) against standard-of-care postoperative stereotactic radiation therapy (SRT). After one year, patients treated with TBRT had a 1.3% rate of recurrence at the surgical site compared to 15.4% of patients in the SRT arm, a dramatic improvement meaning patients and their doctors were much less likely to face the challenges of salvage procedures such as additional surgery or radiation. Median overall survival, a key secondary endpoint of the trial, was 42.5 months with TBRT – more than double the 17.6 months seen with standard SRT.
“Implanting the radioactive tiles at the time of surgery guarantees that patients receive their treatment immediately, along with focal dose escalation, thereby having meaningful impact on local tumor control,” Weinberg said. “From a patient standpoint, we’re showing that there’s almost four times the length of local control and an increase in overall survival. It’s not just a little difference. It’s a massive difference.”