Window of Opportunity Clinical Trials to Evaluate Novel Therapies for Brain Tumors

Neurosurg Clin N Am. 2021 Jan;32(1):93-104. doi: 10.1016/j.nec.2020.09.002. Epub 2020 Nov 5.

Abstract

Despite significant improvement in understanding of molecular underpinnings driving glioblastoma, there is minimal improvement in overall survival of patients. This poor outcome is caused in part by traditional designs of early phase clinical trials, which focus on clinical assessments of drug toxicity and response. Window of opportunity trials overcome this shortcoming by assessing drug-induced on-target molecular alterations in post-treatment human tumor specimens. This article provides an overview of window of opportunity trials, including novel designs for incorporating biologic end points into early stage trials in context of brain tumors, and examples of successfully executed window of opportunity trials for glioblastoma.

Keywords: Biologic end points; Biomarkers; Brain tumors; Clinical trials; Immunotherapy; Molecular markers; Oncology; Window of opportunity.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / therapy*
  • Clinical Trials as Topic
  • Drug Evaluation / methods*
  • Endpoint Determination
  • Glioblastoma / diagnosis*
  • Glioblastoma / therapy*
  • Humans

Substances

  • Biomarkers, Tumor