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BrainStorm: a multicenter international study to tackle CNS metastases in solid tumors

Nature Medicine volume 29, pages 2981–2982 (2023)Cite this article

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Clinical outcomes of patients with central nervous system (CNS) metastases remain disappointing despite recent advances. This medical condition represents an important unmet clinical need in the care of patients with cancer. The occurrence of CNS metastases is increasing along with prolonged survival of patients with metastatic disease owing to improved diagnostic techniques and advanced systemic treatment approaches. The incidence of CNS metastases differs by primary cancer, varying from approximately 5% to 50%1. The most common cancers presenting dissemination to the CNS are lung cancer, breast cancer, melanoma and renal cell carcinoma1. The diagnosis of CNS metastases is associated with a poor prognosis, with overall survival varying from 3 to 25 months depending on the primary cancer1. Treatment options are limited and usually involve multimodality approaches that include surgery, radiotherapy, radiosurgery and sometimes systemic therapy, depending on the number of CNS lesions, location and primary tumor type, as well as the patient’s performance status based on validated prognostic indexes2,3. Several challenges are limiting the advances in this field, including: incomplete knowledge of the CNS metastasis evolving epidemiology; scarce data about the tumor biology of CNS metastasis and its interaction with the tumor microenvironment; and inappropriate preclinical and clinical research methodology and experiments in this field.

In this context, a multidisciplinary Brain Metastases Clinical Research Platform named the BrainStorm program was launched in 2020 by the Institut Jules Bordet, within the Oncodistinct network (ClinicalTrials.gov ID NCT04109131). The BrainStorm program is an international, multicenter, prospective interventional study that is focused on individuals with newly diagnosed non-CNS metastatic solid tumors with a high risk of developing CNS metastases. This program is building a large clinico-pathological database of around 600 patients to investigate the development and epidemiology of CNS metastases, focusing on three time periods: before the diagnosis; at diagnosis; and after the diagnosis of CNS metastases (Table 1).

Table 1 BrainStorm study design
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Acknowledgements

This study is funded by L’Association Jules Bordet, Fonds Gaston Ithier, Fondation Cancer du Luxembourg, Fondation Contre le Cancer, and Fund iris-Research from King Baudouin Foundation. The study was developped with the help of the Oncodistinct network investigators.

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Author notes

  1. These authors contributed equally: Diogo Martins-Branco, Guilherme Nader-Marta.

Authors and Affiliations

  1. Academic Trials Promoting Team (ATPT), Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium

    Diogo Martins-Branco & Guilherme Nader-Marta

  2. Oncology Medicine Department, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium

    Andrea Gombos, Ahmad Awada & Nuria Kotecki

  3. Institut de Cancerologie Strasbourg Europe, Strasbourg, France

    Philippe Barthelemy

  4. Institut Paoli-Calmettes, Marseille, France

    Anthony Goncalves

  5. Department of Drug Development and Innovation (D3i), Institut Curie, Paris, France

    Edith Borcoman

  6. Department of Medical Oncology, Centre Henri Becquerel, Rouen, France

    Florian Clatot

  7. CHU Ambroise Pare, Mons, Belgium

    Stephane Holbrechts

  8. IUCT Oncopole - Institut Claudius Regaud, Toulouse, France

    Eleonora De Maio D’Esposito

  9. Centre Oscar Lambret, Lille, France

    Claire Cheymol

  10. CHU UCL Namur, site Sainte-Elisabeth Hospital, Namur, Belgium

    Vincent Vanhaudenarde

  11. Cliniques Universitaires Saint-Luc, UC Louvain, Brussels, Belgium

    Francois P. Duhoux

  12. Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg

    Caroline Duhem

  13. Department of Medical Oncology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium

    Lore Decoster

  14. Universitair Ziekenhuis Gent, Ghent, Belgium

    Hannelore Denys

  15. Cliniques Universitaire de Bruxelles - Hôpital Erasme, Brussels, Belgium

    Florence Lefranc

  16. Grand Hopital de Charleroi, Charleroi, Belgium

    Jean-Luc Canon

  17. Department of Oncology, Leuven Cancer Institute, UZ Leuven and KU Leuven, Leuven, Belgium

    Paul M. Clement

  18. Institut Universitaire de Cancérologie AP-HP Sorbonne Université, InsermU938, Association Sarah Penalver Gorsd, Paris, France

    Joseph Gligorov

  19. Data Center, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium

    Marianne Paesmans

  20. Laboratory of Clinical and Experimental Oncology, Institut Jules Bordet, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium

    Nadège Kindt

Authors
  1. Diogo Martins-Branco
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  2. Guilherme Nader-Marta
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  5. Anthony Goncalves
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  6. Edith Borcoman
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  7. Florian Clatot
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  8. Stephane Holbrechts
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  9. Eleonora De Maio D’Esposito
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  10. Claire Cheymol
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  11. Vincent Vanhaudenarde
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  12. Francois P. Duhoux
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  13. Caroline Duhem
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  14. Lore Decoster
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  15. Hannelore Denys
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  16. Florence Lefranc
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  17. Jean-Luc Canon
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  18. Paul M. Clement
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  19. Joseph Gligorov
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  20. Marianne Paesmans
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  21. Nadège Kindt
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  22. Ahmad Awada
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  23. Nuria Kotecki
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Corresponding author

Correspondence to Nuria Kotecki.

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Competing interests

D.M.B. received honoraria from Daiichi Sankyo, Novartis, Merck Sharp & Dohme, Janssen, Pfizer, Angelini and AstraZeneca; meeting or travel grants from Novartis, Merck Sharp & Dohme, LEO Farmacêuticos, Ipsen, Janssen, Roche, Laboratórios Vitória and Gilead Sciences; and institutional grants from Novartis and F. Hoffmann-La Roche Ltd (outside the submitted work); G.N.M. received travel grants for meetings from Roche and Bayer (outside the submitted work); A. Gombos has served on the advisory board for AstraZeneca, Daiichi Sankyo and Seattle Genetics; received travel grants from Pfizer and Astra Zeneca; and educational fees from Eli Lilly; E.B. received honoraria from Eisai, Merck Sharp & Dohme, Sandoz and Amgen; meeting or travel grants and non-financial support from Daiichi Sankyo, Eisai, Amgen, Sandoz, Merck Sharp & Dohme, Bristol-Myers Squibb, Novartis, Pfizer and Roche; and has consulted for Egle Tx; F.C. received honoraria or travel grants from Astra Zeneca, BMS, Merck, MSD, Lilly, Roche, Novartis, Pfizer and Gilead (outside the submitted work); S.H. received honoraria from Brystol Myers Squibb, and travel grants from Roche; C.C. received travel grants for meetings from Lilly Oncology and Pfizer; and honoraria from Lilly Oncology (outside the submitted work); F.P.D. received a postdoctoral research grant from Fondation Belge Contre le Cancer; consulting fees from Amgen, Astrazeneca, Daiichi Sankyo, Eli Lilly, Gilead Sciences, MSD, Novartis, Pfizer, Pierre Fabre, Roche and Seagen; and travel support from Amgen, Daiichi Sankyo/AstraZeneca, Gilead Sciences, Pfizer, Roche and Teva (outside the submitted work); L.D. received consulting fees to UZ Brussel from MSD, BMS, Astra Zeneca, Roche and Servier; and travel support from MSD and Roche; H.D. received consulting fees (advisory role) paid to their institution by Pfizer, Roche, PharmaMar, AstraZeneca, Eli Lilly, Novartis, Amgen, GSK, MSD, Seagen, Gilead; and other fees paid to their institution (travel, accommodations, expenses) by Pfizer, Roche, PharmaMar, Teva, AstraZeneca, MSD, GSK and Gilead (all outside the submitted work); P.M.C. reports study budget funds from AstraZeneca; and was an advisory board member for AbbVie, AstraZeneca, Bayer, Bristol Myers Squibb, Daiichi-Sankyo, Leo Pharma, Merck Serono, MSD, Rakuten and Vifor Pharma; J.G. received honoraria from Astra Zeneca, Daiichi, Eisai, Exact Science, Eva Pharm, Lilly, Menarini, Merck Sharp & Dohme, Novartis, Onxeo, Pfizer, Roche Genentech, Seattle Genetics and Sothema; meeting or travel grants from Astra Zeneca, Daiichi, Eisai, Eva Pharm, Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Roche Genentech, Seattle Genetics and Sothema; and research support from Eisai, Exact Science and Roche Genentech; A.A. had an advisory role for Amgen, AstraZeneca, Bayer, Daiichi, EISAI, Genomic Health, Hengrui, Innate, Ipsen, Leo Pharma, Lilly, Merck, MSD, Novartis, Pfizer, Seattle Genetics, Viatris and Menarini; speaker fees from Amgen, AstraZeneca, Bayer, Daiichi, EISAI, Genomic Health, Ipsen, Leo Pharma, Lilly, Merck, MSD, Novartis, Pfizer and Seattle Genetics; and received research grants to their institution from BMS and Roche; N. Kotecki received meeting or travel grants from Ose Immunotherapeutics (outside the submitted work). P.B., A. Goncalves, E.D.E., V.V., C.D., F.L., J.L.C., M.P. and N. Kindt have no conflicts of interest to declare.

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Martins-Branco, D., Nader-Marta, G., Gombos, A. et al. BrainStorm: a multicenter international study to tackle CNS metastases in solid tumors. Nat Med 29, 2981–2982 (2023). https://doi.org/10.1038/s41591-023-02595-y

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