ESTRO 2025 - Abstract Book

S1398

Clinical - Lung

ESTRO 2025

3521

Digital Poster Multi-omics integrative modelling for SBRT in early-stage non-small cell lung cancer: report on the first 100 patients of the MONDRIAN study Stefania Volpe 1,2 , Ilaria Repetti 1,2 , Gaia Piperno 1 , Mattia Zaffaroni 1 , Maria Giulia Vincini 1 , Federica Bellerba 3 , Konstantinos Venetis4 4 , Mariano Lombardi 4 , Eltjona Mane 4 , Stefano Maria Donghi 5 , Cristiana Fodor 1 , Maria Alessia Zerella 1 , Sabrina Clobiaco 1,2 , Giuseppina Bonizzi 6 , Tiziana Bonaldi 2,3 , Nicola Fusco 4,2 , Cristina Garibaldi 7 , Francesco Ceci 2,8 , Giuseppe Petralia 9,2 , Sara Gandini 3 , Monica Casiraghi 2,10 , Lorenzo Spaggiari 10,2 , Roberto Orecchia 11 , Barbara Alicja Jereczek-Fossa 1,2 1 Division of Radiation Oncology, European Institute of Oncology IRCCS, Milan, Italy. 2 Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy. 3 Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy. 4 Division of Pathology, European Institute of Oncology IRCCS, Milan, Italy. 5 Division of Interventional Pulmonology, European Institute of Oncology IRCCS, Milan, Italy. 6 Biobank for Translational and Digital Medicine, European Institute of Oncology IRCCS, Milan, Italy. 7 Unit of Radiation Research, European Institute of Oncology IRCCS, Milan, Italy. 8 Division of Nuclear Medicine, European Institute of Oncology IRCCS, Milan, Italy. 9 Radiology Division, European Institute of Oncology IRCCS, Milan, Italy. 10 Department of Thoracic Surgery, European Institute of Oncology IRCCS, Milan, Italy. 11 Scientific Directorate, European Institute of Oncology IRCCS, Milan, Italy Purpose/Objective: The main treatment options for early-stage non-small cell lung cancer (ES-NSCLC) are surgery or stereotactic body radiation therapy (SBRT). Given the issue of regional and distant failure in SBRT, identifying predictive factors is essential to select patients who may benefit from more aggressive approaches. Hence, the MONDRIAN trial aims to identify multi-omic biomarkers of SBRT response by integrating the fields of radiomics, genomics and proteomics.

Material/Methods:

MONDRIAN is a prospective observational cohort study, with a data-driven, bottom-up approach. It is expected to enroll 100 patients treated with SBRT and 200 treated with surgery,to discriminate between predictors specific to SBRT from disease-related prognosticators. The project will have an overall duration of 60 months, and is articulated into five main tasks: clinical; imaging, gene expression, proteomic, and integrative model building. The primary endpoint is progression-free survival, while secondary endpoints include investigation of predictive biomarkers the clinical, imaging, genomic and proteomic domains, and the longitudinal validation of gene expression and proteomics profiling in tissuesand liquid biopsies. An overview of the study workflow is provided in Figure 1 . For eligibility, patients are required to have histopathological confirmation of ES-NSCLC, staged per the 8 th edition of the TNM, ECOG performance status of 0-1, no prior diagnosis of other invasive cancers within three years, no absolute contraindication to either surgery or SBRT, or diagnosis of mental disorders preventing the acquisition of a valid informed consent.. The study has been approved by the Institutional Ethical Committee and is registered as NCT05974475.