As the population of cancer survivors increases in the United States, the overall incidence of cancer metastasizing to the brain and spine is increasing as well, with an annual estimate of more than 280,000 new cases from all cancer types. In response to this growing need for patient care, several personalized medicine trials are now available through the Duke Center for Brain and Spine Metastasis (DCBSM), one of the only research programs of its kind.
The center—led by neurosurgeon Peter E. Fecci, MD, PhD, medical oncologist Carey K. Anders, MD, spine surgeon C. Rory Goodwin, MD, PhD, and radiation oncologist John P. Kirkpatrick, MD, PhD—was established in 2017. Anders, the DCBSM medical director, notes that there has been a true paradigm shift over the past few years of historically excluding patients with brain and spine metastases from clinical trials to designing trials specifically for them prior to local therapy.
“These patients—especially those with leptomeningeal disease—have historically been excluded from participating in any type of clinical trial opportunity due to a history of central nervous system disease,” she says. “At Duke, our focus is on developing trials that are geared toward these patient populations, the specific types of molecular alterations that the metastasis may have, the side effects of treatments, and quality-of-life considerations that are very unique to this patient population.”