MINTER Trial: Metal Intervention aNd ThErapy With Radiotherapy In Thoracic Cancer Using Copper Donor Therapy: A Phase 2, Open-Label Study

1. Histologically confirmed locally advanced or metastatic disease of any histology that will receive chest radiation
2. Scheduled to receive RT as part of definitive local consolidation therapy (LCT) (not palliative)
3. Induction systemic therapy allowed, but just not concurrently given (washout for at least 3 weeks before start of CDT and RT)
4. Age ≥18 years.
5. ECOG 0-2.

6. Adequate organ and marrow function within 28 days prior to enrollment defined as:

   • Absolute neutrophil count (ANC) ≥1.5 × 10⁹/L
   • Platelet count ≥100 × 10⁹/L
   • Hemoglobin ≥9 g/dL
   • Serum creatinine ≤1.5 × upper limit of normal (ULN) or creatinine clearance ≥50 mL/min
   • Total bilirubin ≤1.5 × ULN (≤3 × ULN for patients with known Gilbert's syndrome)
   • AST and ALT ≤2.5 × ULN (≤5 × ULN for patients with hepatic metastases)
7. Ability to provide written informed consent.
8. Prior thoracic radiation allowed as long as cumulative organ as risk constraints are met

Exclusion Criteria:

1. Uncontrolled intercurrent illness.
2. Known hypersensitivity to Disulfiram.
3. Contraindications to radiation therapy.
4. Inability to stay away from alcohol products during the use of Disulfiram.
5. Wilson's Disease (copper overload disorder)
6. Hepatic dysfunction with AST/ALT/bilirubin levels that are outside 2.5 X normal range (≤2.5 × ULN)
7. Hypersensitivity to copper-containing compounds