Brain metastases included by default in every solid-tumour trial
Up to a fifth of people with advanced solid tumours have cancer in the brain and are usually barred from trials. Letting in those whose brain disease is treated, stable or symptom-free would widen trials and tell us whether drugs work in the brain.
Protocols would include patients with treated and stable brain metastases, and asymptomatic untreated metastases below a size threshold, with a pre-specified intracranial response assessment (RANO-BM) as a secondary endpoint. Exclusion would be allowed only for agents with a documented neurotoxicity signal or where the sponsor pre-registers a separate CNS cohort. The FDA brain metastases eligibility guidance supports this but uptake remains partial.
- Trials enrol too few, too slowly · Fewer than one in ten adults with cancer joins a trial. Trials close for lack of patients, not lack of ideas.
- The brain: barrier and sanctuary · Most drugs cannot cross into the brain, so brain tumours and brain metastases lag every other site.
Pages like this
not linked directly; found by shared links- IdeaTreat brain metastases as a disease with its own trials programme
Shares Tucatinib, Osimertinib, The brain: barrier and sanctuary, HER2-positive breast cancer.
- IdeaPrevention trials aimed only at brain metastasis
Shares Tucatinib, Lorlatinib, MRI, Osimertinib.
- IdeaSystemic-first management of HER2-positive brain metastases
Shares Tucatinib, The brain: barrier and sanctuary, Trastuzumab deruxtecan, HER2-positive breast cancer.
- IdeaBuild a human model of the barrier that guards the brain fluid
Shares The brain: barrier and sanctuary, HER2-positive breast cancer, Melanoma, Non-small-cell lung cancer.
- IdeaUse the brain's own transport door to carry antibody drugs across
Shares Tucatinib, The brain: barrier and sanctuary, Trastuzumab deruxtecan, HER2-positive breast cancer.
- PathwayThe blood–brain barrier & brain metastasis
Shares Tucatinib, Lorlatinib, MRI, Osimertinib.
- TrialDESTINY-Breast12
Shares The brain: barrier and sanctuary, Trastuzumab deruxtecan, HER2-positive breast cancer.
- IdeaA standard platform to get drugs into the brain: focused ultrasound plus shuttle-engineered therapeutics
Shares The brain: barrier and sanctuary, HER2-positive breast cancer, Melanoma, Non-small-cell lung cancer.