Prevention trials aimed only at brain metastasis
Some cancers reach the brain in up to a quarter of patients. Prevention trials could aim specifically at stopping that, instead of treating it once it has happened.
Brain-penetrant agents reduce central nervous system progression in metastatic disease, and adjuvant trials have shown CNS event reductions as secondary endpoints. No trial yet uses CNS-metastasis-free survival as a primary endpoint in a population prospectively defined as CNS-high-risk by subtype and risk score. This is a designable, ownable clinical setting rather than a new mechanism.
- Metastasis is understood least and studied last · Metastasis causes about nine in ten cancer deaths but gets a small fraction of research money and almost no trials of its own.
- The brain: barrier and sanctuary · Most drugs cannot cross into the brain, so brain tumours and brain metastases lag every other site.
- Trial design, endpoints and cost · A phase 3 trial takes years and hundreds of millions of dollars, and often answers a question that has already moved on.
Pages like this
not linked directly; found by shared links- IdeaBrain metastases included by default in every solid-tumour trial
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- PathwayThe blood–brain barrier & brain metastasis
Shares Alectinib, HER2-positive brain metastases, Tucatinib, Lorlatinib.
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- IdeaUse the brain's own transport door to carry antibody drugs across
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- PersonNancy U. Lin
Shares HER2CLIMB, Tucatinib, HER2-positive breast cancer.