Eligibility of patients with brain metastases for phase I trials: time for a rethink?

摘要: Since the inception of phase I clinical trials in cancer, patients with symptomatic brain metastases have commonly been excluded from participation because a poor outlook. However, asymptomatic pose an increasingly frequent challenge for clinicians: more sensitive imaging can identify clinically silent metastases; frequency detection might increased changes natural history many tumour types as result effective systemic treatment; and routine screening procedure before entry into trial show lesions which are questionable importance, but frequently preclude enrolment. Evidence suggests that delaying whole-brain radiotherapy until progression has no adverse effect on prognosis. Safety efficacy data accumulating targeted agents to treat metastases. We think subset be appropriately entered trials, we present our approach their stratification. As consequence, access experimental treatments thus interventions developed promptly.