Stop excluding brain metastases from cancer trials
One in five people with advanced cancer has brain spread, yet most trials refuse them. Requiring brain cohorts would give those patients evidence instead of guesswork.
Brain metastasis exclusion criteria persist by habit, and regulators and professional bodies have issued guidance encouraging inclusion of patients with stable treated brain metastases. Making a CNS cohort with CNS-specific response endpoints a default expectation for registrational trials in CNS-tropic cancers, unless justified otherwise, would generate labelled intracranial data rather than post-approval retrospectives.
- The brain: barrier and sanctuary · Most drugs cannot cross into the brain, so brain tumours and brain metastases lag every other site.
- 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.
- 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- IdeaPrevention trials aimed only at brain metastasis
Shares ALINA, HER2CLIMB, HER2-positive brain metastases, The brain: barrier and sanctuary.
- IdeaSystemic-first management of HER2-positive brain metastases
Shares HER2CLIMB, HER2-positive brain metastases, The brain: barrier and sanctuary.
- PairingTucatinib + trastuzumab + capecitabine for brain metastases
Shares HER2CLIMB, HER2-positive brain metastases.
- IdeaAgree in advance how to borrow evidence between similar rare cancers
Shares European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO), Trial design, endpoints and cost.
- TrialDESTINY-Breast12
Shares HER2-positive brain metastases, The brain: barrier and sanctuary.
- IdeaCap public prices for new cancer drugs to tiers of the ESMO and ASCO value scales
Shares European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO).
- IdeaMicro-learning pushed to community oncologists within 30 days of a practice change
Shares European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO).
- IdeaEvery payer covers routine care costs for trial participants, in every country
Shares American Society of Clinical Oncology (ASCO), Trials enrol too few, too slowly.