Design and conduct of theranostic trials in neuro-oncology: Challenges and opportunities

Patrick Y Wen1, Matthias Preusser2, Nathalie L Albert3

  • 1Center For Neuro-Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA.

Neuro-Oncology
|October 5, 2024
PubMed

Insights

Theranostics combines molecular imaging and targeted radionuclide therapy for cancer treatment. Designing clinical trials for brain tumors requires careful consideration of the blood-brain barrier and response criteria.

Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiology

Background:

  • Theranostics integrates molecular imaging and targeted radionuclide therapy.
  • Approved agents exist for systemic cancers, with potential in neuro-oncology.
  • Brain tumor clinical trials require specific considerations.

Purpose of the Study:

  • To discuss key issues in designing clinical trials for theranostic agents in neuro-oncology.
  • To highlight the need for specialized approaches in brain tumor theranostics.

Main Methods:

  • Review of existing literature and clinical trial methodologies in neuro-oncology.
  • Discussion of challenges specific to brain tumor treatment evaluation.

Main Results:

  • Clinical trials for brain tumors necessitate evaluation of blood-brain barrier penetration.
  • Optimizing eligibility criteria and response assessments (e.g., pseudoprogression) is crucial.
  • Lessons from other neuro-oncology treatments inform theranostic trial design.

Conclusions:

  • Designing effective theranostic clinical trials for brain tumors requires addressing unique challenges.
  • Molecular imaging and careful endpoint selection are vital for success.
  • Further research is needed to optimize theranostic agent application in neuro-oncology.

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