Real-time monitoring of lung tumors during radiotherapy

MAGIK: Using Implanted Markers to Determine the Feasibility of Markerless Image Guidance Using Intrafraction Kilovoltage X-ray Imaging: A Phase I Interventional Study of Lung Cancer Radiotherapy

Not applicable Interventional University of Sydney · NCT04086082

This study is testing a new technology that tracks lung tumors in real-time during radiation treatment to see if it can make the treatment more precise for lung cancer patients.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment30 (estimated)
Ages18 Years and up
SexAll
SponsorUniversity of Sydney Academic / other
Drugs / interventionsbevacizumab, sunitinib, chemotherapy
Locations1 site (Melbourne, Victoria)
Trial IDNCT04086082 on ClinicalTrials.gov

What this trial studies

This trial investigates the feasibility of Markerless Tumour Tracking technology, which integrates with existing treatment machines to monitor tumor motion in real-time during radiotherapy. Patients will receive standard care while undergoing continuous kilovoltage x-ray imaging to evaluate the accuracy of this tracking method. The study aims to improve treatment precision for patients with lung cancer by using fiducial markers as a reference for tracking tumor movement.

Who should consider this trial

Good fit: Ideal candidates include patients with Stage I non-small cell lung cancer or oligometastatic lung metastases who are undergoing external beam radiotherapy.

Not a fit: Patients with low respiratory performance or those who have previously received high-dose thoracic radiotherapy may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could enhance the accuracy of lung cancer treatments, potentially leading to better patient outcomes.

How similar studies have performed: While the concept of real-time tumor tracking is being explored, this specific markerless approach is relatively novel and has not been extensively tested in prior studies.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Is willing to comply with all trial procedures and intends to provide written Informed Consent for participation in this trial.
* Patients undergoing external beam radiotherapy.
* Histologically proven Stage I NSCLC or oligometastatic lung metastases (3 or less).
* MRI/4D-CT prior to insertion of fiducial markers.
* Patient must be able to have fiducial markers placed in the lung (if on anticoagulants, must be cleared by LMO or cardiologist).
* ECOG performance status 0-2.
* A maximum of three metastases to the lung from any non-haematological malignancy. Multiple metastases will be treated separately.
* 1 cm ≤ Tumour diameter in any dimension ≤ = 5 cm.
* The distance between the tumour centroid and the top end of the diaphragm is \<=10 cm.

Exclusion Criteria:

* Patient has low respiratory performance as evaluated by the physicians.
* Previous high-dose thoracic radiotherapy.
* Less than one fiducial marker implanted in the lung.
* Fiducial markers are too far from the tumour centroid (\>9 cm).
* Cytotoxic chemotherapy within 3 weeks of commencement of treatment, or concurrently with treatment. Hormonal manipulation agents are allowable (e.g. aromatase inhibitors, selective oestrogen receptor modulators, and gonadotropin releasing hormone receptor modulators).
* Targeted agents (such as sunitinib, bevacizumab and tarceva) within 7 days of commencement of treatment, or concurrently with treatment.
* Women who are pregnant or lactating.
* Unwilling or unable to complete quality of life questionnaires.

Where this trial is running

Melbourne, Victoria

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Lung CancerLung cancerNSCLCOligometastases
Last reviewed 2026-06-10 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.