The BRITEMET study: BRain dIffusion TEnsor imaging to predict immunotherapy response in METastatic melanoma

This study is about determining whether cancer patients are going to respond to immunotherapy using magnetic resonance imaging (MRI). Secondary tumours or metastases are a common problem and in the brain can cause death and disability for millions of patients. Immunotherapy is a revolutionary treatment, stimulating the body’s own immune system to fight cancer. Unfortunately it does not work for every patient and there is no simple test to determine who will benefit. We have shown that special MRI scans can detect inflammation in the brain and we know that this should predict a good response to immunotherapy. We wish to perform these special MRI scans, called diffusion tensor scans, in adult patients who are being treated for brain metastases from one cancer type only in the first instance, melanoma. This is to limit any variability in the results that may come from different types of tumour, although in future we would hope to apply the technique to other cancers. Adult patients seen at Clatterbridge Cancer Centre will be recruited and asked to attend for the additional short (less than 30 minutes) brain scan at the Walton Centre prior to starting their immunotherapy. There is no change to the drugs or surgeries they receive, we simply record all this information and see how they respond to their treatment by 12 weeks. We will subsequently go back, analyse the data and see if the MRI scans could have predicted who would and would not respond from the beginning. Our secondary aim is to improve how we measure the degree of inflammation from these scans to make the readings more reliable in future. The information provided by this small study of around 20 patients will hopefully allow a larger trial to be conducted in future and improve the treatment of this condition.


The chief investigators for this study are Rasheed Zakaria & Michael Jenkinson at The Walton Centre and Dr Joseph Sacco at Clatterbridge Cancer Centre. The study is funded by CRUK and The RCSEng.

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