Trial supports MRI surveillance over preventive brain radiation in small-cell lung cancer
Results from the international phase 3 SWOG S1827 MAVERICK trial show that brain MRI surveillance alone improved cognitive failure-free survival compared with MRI surveillance plus prophylactic cranial irradiation (PCI) in patients with small-cell lung cancer (SCLC). The findings support MRI surveillance alone as the standard of care for patients with SCLC, according to research presented at the…
A recent phase 3 trial, SWOG S1827 MAVERICK, has shown that MRI surveillance alone can be as effective as MRI surveillance plus prophylactic cranial irradiation (PCI) in preventing cognitive decline in patients with small-cell lung cancer (SCLC). The international trial enrolled 304 patients from January 2020 to December 2025 and found that MRI surveillance alone significantly improved cognitive failure-free survival compared to MRI surveillance plus PCI (40% reduction in risk).
The benefit was consistent across limited-stage and extensive-stage SCLC patients, regardless of immunotherapy use. Over a median follow-up of 22 months, brain metastasis-free survival was not significantly different between the two groups. Serious treatment-related adverse events were less frequent with MRI surveillance alone, with only 0.8% of patients experiencing Grade 3-5 adverse events compared to 7.9% in the MRI plus PCI group.
Dr. Chad Rusthoven, presenting the findings at the IASLC 2026 World Conference on Lung Cancer, stated that these results support MRI surveillance alone as the standard of care for SCLC patients.
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