Reducing the Incidence of Symptomatic Brain Metastases With MRI Surveillance

Inclusion Criteria:

• Age ≥ 18 years of age.

• Patients with non-squamous locally advanced lung cancer defined by American JointCommittee on Cancer (AJCC) version 8 stage IIIA, IIIB, or IIIC disease.

• Histology described as adeno-squamous or not otherwise specified favoring squamousare eligible.

• Patients may be enrolled before or after the start of radiation therapy but must beenrolled and have their first surveillance MRI brain at 120 +/- 10 days of theirfirst treatment of radiation therapy for their locally advanced lung cancer. Thefirst radiation treatment is defined as day 1.

• Eastern Cooperative Oncology Group (ECOG) performance status of 0 - 3.

• Epidermal growth factor receptor (EGFR) > 30 mL/min/1.73m2.

• Patients must be eligible for a brain MRI per the Wake Forest MRI safety screeningchecklist questionnaire. This will be completed by a MRI imaging technician,enrolling physician, CPDM staff member, a magnetic resonance safety officer, and/ora radiologist as indicated in the form.

Exclusion Criteria:

• Known brain metastases on staging MRI.

• Questionable findings that may represent a differential of vasculatureabnormalities/stroke/ and or metastatic disease with recommended short intervalfollow-up are not an exclusion factor for study participation. The recommendedfollow-up imaging for such findings should have no bearing on the imaging schedulein this protocol, and this research protocol imaging should NOT serve as an officialfollow-up scan for such findings.

• Patients who are pregnant or breastfeeding.

• Premenopausal persons of childbearing potential must have a negative pregnancy testwithin 14 days of enrollment. If women are not of childbearing potential as definedby women who are menopausal female or has had a hysterectomy, bilateraloophorectomy, or medically-documented ovarian failure, they will not require apregnancy test. Should a woman become pregnant or suspect she is pregnant while sheor her partner is participating in this study, she should inform her treatingphysician immediately.