DYNAMIC ” IDentifY the best therapeutic sequeNcing strAtegy in oncogene addICted NSCLC:” “A multi-arms prospective, randomized phase II study to evaluate the best sequential therapeutic strategis in patients with metastatic non-small cell lung cancer harboring targetable genomic driver alterations”
Non-small cell lung cancer is the most common type of lung cancer. In some people, the cancer cells carry specific gene changes that help the tumour grow. Doctors now have several modern treatments for these cancers, including targeted therapies that block specific gene faults, immunotherapy, and standard chemotherapy. While these medicines are effective, doctors do not yet know the best order in which to give them. The DYNAMIC trial aims to find the ideal sequence of treatments for adults whose lung cancer has spread to other parts of the body. Participants will be placed into groups to receive different sequences of approved cancer medicines. Researchers will follow patients for at least two years to measure how long the cancer stays controlled across their first and second courses of treatment, as well as tracking side effects and daily wellbeing.
At a glance
What is this study about?
Lung cancer is often treated with different types of medicines over time. When a cancer cell has a specific genetic fault that drives its growth, doctors can use 'targeted therapies'. These are modern drugs designed to block those exact faults. Other treatment options include immunotherapy, which helps the body's immune system fight the cancer, and traditional chemotherapy. However, cancer can sometimes become resistant to a treatment, meaning a new medicine is needed.
Currently, it is not completely clear which order of treatments gives patients the best long-term outcome. The DYNAMIC clinical trial is designed to test different treatment sequences in people with advanced or metastatic non-small cell lung cancer. By comparing different treatment paths, the study aims to identify the most effective order to help people live longer, healthier lives.
In this trial, patients are assigned to receive specific medicines in a planned order based on the precise genetic features of their cancer. Doctors will closely track how the cancer responds to both the initial treatment and the follow-up treatment. They will also look at how treatments affect everyday quality of life and measure any unwanted side effects.
Key takeaways
- The DYNAMIC trial is studying the best order to give treatments for advanced non-small cell lung cancer.
- It focuses on cancers that have specific, identifiable genetic changes.
- Treatments include targeted therapy tablets, immunotherapy, and chemotherapy.
- The main goal is to see which treatment sequence keeps the cancer controlled best over two years.
- Taking part is completely voluntary and involves regular health checks and hospital visits.
Who may be eligible?
This trial is for adults aged 18 and older who have been diagnosed with advanced or metastatic non-small cell lung cancer. 'Metastatic' means the cancer has spread beyond the lung to other parts of the body.
To be considered, your tumour must have a confirmed 'targetable' gene change. Your medical team usually checks for these changes by doing specialised tests on a small sample of your tumour or through a blood test. Common examples of these gene changes include EGFR, ALK, KRAS, BRAF, MET, and RET mutations.
You will also need to meet general health requirements to ensure it is safe for you to take part. This usually includes having reasonably good kidney, liver, and heart function, and being well enough to carry out everyday activities.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- I am aged 18 or older.
- I have been diagnosed with non-small cell lung cancer that has spread (metastatic).
- My cancer has been tested and shows a specific gene change (such as EGFR, ALK, KRAS, BRAF, or others).
- I am well enough to attend regular hospital appointments and take part in everyday tasks.
- I am open to receiving cancer treatments through tablets, hospital drips, or both.
What does participation involve?
If you decide to take part, your medical team will first perform screening tests, such as blood tests and scans (like CT or PET scans), to confirm that the trial is safe and suitable for you. You will then be assigned to a treatment sequence based on the exact genetic characteristics of your tumour.
Depending on which medicines you are given, you may take daily tablets at home, receive regular drips (infusions) into a vein at the hospital, or have a combination of both. You will attend regular hospital appointments for safety checks, blood tests, and scans every few weeks or months. You will also be asked to complete short questionnaires about your energy levels, symptoms, and daily wellbeing. The study monitors patients through their first and second lines of treatment, which typically lasts for two years or longer.
Potential risks and benefits
Locations (1)
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Common questions
What does 'treatment sequencing' mean?
Treatment sequencing means planning the order in which different cancer medicines are given, so that when one treatment stops working, the next best option is ready to use.
How do doctors know which gene change my cancer has?
Doctors test a small tissue sample taken during a biopsy, or sometimes a blood sample, to look closely at the cancer's DNA.
Will I receive a dummy drug (placebo)?
No, all participants in this study receive active, approved cancer medicines designed to treat their specific type of cancer.
What happens if my cancer starts growing again?
If your cancer begins to grow or the current medicine stops working, the trial team will review your health and move you onto the next planned treatment in the sequence.
Can I leave the study if the side effects are too difficult?
Yes. You have the right to leave the trial at any point. Your medical team will then discuss other standard treatment options available on the NHS.
How to find out more
Always speak to your GP or specialist before deciding to take part in a study.
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