Treat brain metastases as a disease with its own trials programme
A fifth of patients with solid tumours develop brain metastases and are usually excluded from trials. This would fund a programme that studies and treats them as a disease in their own right.
A funded network of brain-metastasis centres runs dedicated trials (systemic agents with CNS activity, radiosurgery sequencing, prevention in high-risk groups such as HER2-positive breast and EGFR/ALK lung cancer), builds a shared registry and tissue bank of resected metastases, and develops CNS-specific endpoints accepted by regulators. Funders and regulators would jointly discourage the routine exclusion of patients with stable brain metastases from registration trials.
- Funding follows fashion, not burden · Money goes to the cancers and questions that are easy or popular, not the ones that kill most or where a dollar would do most.
- 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- IdeaBrain metastases included by default in every solid-tumour trial
Shares Tucatinib, Osimertinib, The brain: barrier and sanctuary, 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, Glioma & glioblastoma, Melanoma.
- IdeaSystemic-first management of HER2-positive brain metastases
Shares Tucatinib, The brain: barrier and sanctuary, SBRT / SABR (stereotactic radiotherapy), 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.
- IdeaPrevention trials aimed only at brain metastasis
Shares Tucatinib, Osimertinib, The brain: barrier and sanctuary, HER2-positive breast cancer.
- IdeaUse the brain's own transport door to carry antibody drugs across
Shares Tucatinib, The brain: barrier and sanctuary, HER2-positive breast cancer, Non-small-cell lung cancer.
- TrialHER2CLIMB-02
Shares Tucatinib, HER2-positive breast cancer.
- PathwayThe blood–brain barrier & brain metastasis
Shares Tucatinib, Osimertinib, The brain: barrier and sanctuary, SBRT / SABR (stereotactic radiotherapy).