Condition

Brain and central nervous system cancer

Clinical trials and treatment information for Brain and central nervous system cancer

975K
People Affected
80
Active Trials
390K
New Cases/Year
259K
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Temozolomide + Radiation Therapy
70% Effectiveness• 90% Confidence• 30% Safety• 141 trials• 35K participants
HIGH EvidenceModerate ValueDose: RT: 60 Gy in 30 fractions; TMZ: 75 mg/m2 daily concurrently, then 150-200 mg/m2 daily for 5 days every 28 days
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Comparative Safety Scale(Higher is safer)

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30
DangerousModerateSafe

Time to Effect

6-12 months

Duration

6-12 months

Response Rate

35%

Remission Rate

5%

Number Needed to Treat (NNT)

6

Number Needed to Harm (NNH)

10

Common Side Effects:

Nausea/Vomiting: 50%
Fatigue: 60%
Myelosuppression (Thrombocytopenia, Neutropenia): 30%
Alopecia: 25%
Headache: 25%

Annual Cost of Care

Drug Cost

$30,000

Monitoring

$18,000

Side Effects

$8,000

Total Annual

$56,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.19

ICER

$150,000/QALY

Cost per Remission

$1,120,000

Cost per Responder

$160,000

Treatment Outcomes
Primary Outcomes
Overall SurvivalMedian of 12.1 months (with radiation alone)
+20.7% (+2.5 months)
Progression-Free SurvivalMedian of 5.0 months (with radiation alone)
+38% (+1.9 months)
One-year Survival Rate50.4% (with radiation alone)
+21.2% (+10.7 percentage points)
Secondary Benefits
Global Health Status/QoL (EORTC QLQ-C30)70 (0-100 scale, higher is better)
-7.1% (-5 points)
Fatigue (EORTC QLQ-C30)40 (0-100 scale, higher is worse)
-0.75% (-0.3 points)
Seizure FrequencyAverage of 4 seizures/month
-50% (-2 seizures/month)
Common Side Effects
Nausea/Vomiting
+50%
Fatigue
+60%
Myelosuppression (Thrombocytopenia, Neutropenia)
+30%

Clinical Trial Phases:

Phase 3Phase 4
2
Tumor Treating Fields (Optune)
65% Effectiveness• 85% Confidence• 70% Safety• 7 trials• 5K participants
HIGH EvidencePoor ValueDose: Continuous wear of transducer arrays >18 hours/day
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Comparative Safety Scale(Higher is safer)

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70
DangerousModerateSafe

Time to Effect

3-6 months

Duration

lifetime / until progression

Response Rate

%

Remission Rate

1%

Number Needed to Treat (NNT)

13

Number Needed to Harm (NNH)

100

Common Side Effects:

Skin irritation/rash: 45%
Headache: 15%
Fatigue: 15%

Annual Cost of Care

Drug Cost

$250,000

Monitoring

$5,000

Side Effects

$1,000

Total Annual

$256,000

Cost-Effectiveness

POOR

QALYs Gained

0.25

ICER

$500,000/QALY

Treatment Outcomes
Primary Outcomes
Overall SurvivalMedian OS with TMZ alone: 16.0 months
+30.6% (+4.9 months)
Progression-Free SurvivalMedian PFS with TMZ alone: 4.0 months
+67.5% (+2.7 months)
1-Year Survival Rate50% (patients alive at 1 year with TMZ alone)
+46% (+23 percentage points)
2-Year Survival Rate16% (patients alive at 2 years with TMZ alone)
+168.8% (+27 percentage points)
Secondary Benefits
Time to KPS deterioration (≥10-point decrease)Median time with TMZ alone: 5.5 months
+45.5% (+2.5 months)
Time to HRQoL deterioration (≥10-point decrease in EORTC QLQ-C30 GHS)Median time with TMZ alone: 5.0 months
+50% (+2.5 months)
Common Side Effects
Skin irritation/rash
+45%
Headache
+15%
Fatigue
+15%

Clinical Trial Phases:

Phase 3Phase 4
3
Radiation Therapy
60% Effectiveness• 95% Confidence• 25% Safety• 658 trials• 50K participants
HIGH EvidenceGood ValueDose: 60 Gy in 30 fractions
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Comparative Safety Scale(Higher is safer)

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Meth💀
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Chemo☢️
Alcohol🍺
Morphine💊
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25
DangerousModerateSafe

Time to Effect

3-6 months

Duration

6 weeks

Response Rate

45%

Remission Rate

5%

Number Needed to Harm (NNH)

15

Common Side Effects:

Fatigue: 70%
Hair loss: 90%
Skin irritation: 60%
Nausea/Vomiting: 30%
Cognitive impairment (long-term): 40%

Annual Cost of Care

Drug Cost

$0

Monitoring

$10,000

Side Effects

$3,000

Total Annual

$48,000

Cost-Effectiveness

GOOD

QALYs Gained

0.1

Cost per Remission

$960,000

Cost per Responder

$106,667

Treatment Outcomes
Primary Outcomes
Tumor Volume20 cm^3
-50% (-10 cm^3)
Neurological Symptom Burden (e.g., NANO scale)15/40 (higher score indicates worse symptoms)
-33.3% (-5 points)
Karnofsky Performance Status (KPS)70/100 (lower values indicate greater disability)
+14.3% (+10 points)
Secondary Benefits
EORTC QLQ-C30 Global Health Status60/100 (higher score indicates better QoL)
+10% (+6 points)
Memory Index Score (e.g., from RBANS)75/100 (higher is better, population mean ~100)
+6.7% (+5 points)
Daily Dexamethasone Dose4 mg
-50% (-2 mg)
Common Side Effects
Fatigue
+70%
Hair loss
+90%
Skin irritation
+60%

Clinical Trial Phases:

Phase 3Phase 4
4
Bevacizumab
55% Effectiveness• 80% Confidence• 40% Safety• 117 trials• 10K participants
HIGH EvidencePoor ValueDose: 10 mg/kg IV every 2 weeks
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Comparative Safety Scale(Higher is safer)

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40
DangerousModerateSafe

Time to Effect

1-2 months

Duration

6-18 months

Response Rate

45%

Remission Rate

1%

Number Needed to Treat (NNT)

7

Number Needed to Harm (NNH)

75

Common Side Effects:

Hypertension: 35%
Proteinuria: 25%
Thromboembolic events: 15%
Hemorrhage: 7%
GI perforation: 1%

Annual Cost of Care

Drug Cost

$100,000

Monitoring

$5,000

Side Effects

$5,000

Total Annual

$110,000

Cost-Effectiveness

POOR

QALYs Gained

0.05

ICER

$300,000/QALY

Cost per Responder

$244,444

Treatment Outcomes
Primary Outcomes
Dexamethasone Daily Dose7 mg/day
-60% (-4.2 mg/day)
Karnofsky Performance Status (KPS)KPS score: 60/100
+16.67% (+10 points)
MRI T1 Contrast-Enhancing Lesion Volume25 cm³
-50% (-12.5 cm³)
Secondary Benefits
Global Health Status/QoL (EORTC QLQ-C30)Baseline score: 50/100
+30% (+15 points)
Headache Severity (Numeric Rating Scale)Baseline score: 7/10
-35.7% (-2.5 points)
Fatigue (EORTC QLQ-BN20)Baseline score: 60/100
-25% (-15 points)
Common Side Effects
Hypertension
+35%
Proteinuria
+25%
Thromboembolic events
+15%

Clinical Trial Phases:

Phase 3Phase 4
5
Lomustine
45% Effectiveness• 70% Confidence• 25% Safety• 40 trials• 5K participants
MODERATE EvidenceModerate ValueDose: 100-130 mg/m2 orally every 6 weeks
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Comparative Safety Scale(Higher is safer)

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25
DangerousModerateSafe

Time to Effect

1-3 months

Duration

6-12 months

Response Rate

15%

Remission Rate

1%

Number Needed to Treat (NNT)

7

Number Needed to Harm (NNH)

7

Common Side Effects:

Myelosuppression (Thrombocytopenia, Leukopenia): 70%
Nausea/Vomiting: 60%
Fatigue: 35%
Pulmonary fibrosis: 7%
Hepatotoxicity: 15%

Annual Cost of Care

Drug Cost

$15,000

Monitoring

$5,000

Side Effects

$3,000

Total Annual

$23,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.03

Cost per Responder

$153,333

Treatment Outcomes
Primary Outcomes
Median Overall Survival7 months (recurrent high-grade glioma)
+28.57% (+2 months)
Median Progression-Free Survival2.5 months (recurrent high-grade glioma)
+60% (+1.5 months)
Karnofsky Performance Status (KPS)70 (mild symptoms, able to care for self)
+11.43% (+8 points)
Secondary Benefits
EORTC QLQ-C30 Global Health Status score65 (Moderate QoL impairment, on a 0-100 scale)
+12.31% (+8 points)
Daily Dexamethasone Dose4 mg/day (for patients on baseline steroids)
-37.5% (-1.5 mg/day)
Seizure Frequency2 seizures/month (for patients with baseline seizures)
-35% (-0.7 seizures/month)
Common Side Effects
Myelosuppression (Thrombocytopenia, Leukopenia)
+70%
Nausea/Vomiting
+60%
Fatigue
+35%

Clinical Trial Phases:

Phase 2Phase 3
6
Nivolumab
20% Effectiveness• 80% Confidence• 40% Safety• 41 trials• 8K participants
HIGH EvidencePoor ValueDose: 240 mg IV every 2 weeks or 480 mg IV every 4 weeks
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Comparative Safety Scale(Higher is safer)

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40
DangerousModerateSafe

Time to Effect

2-4 months

Duration

6-12 months

Response Rate

8%

Remission Rate

1%

Number Needed to Harm (NNH)

15

Common Side Effects:

Fatigue: 25%
Rash: 15%
Diarrhea: 15%
Immune-related adverse events: 10%

Annual Cost of Care

Drug Cost

$150,000

Monitoring

$10,000

Side Effects

$8,000

Total Annual

$168,000

Cost-Effectiveness

POOR
0

Cost per Responder

$2,100,000

Treatment Outcomes
Primary Outcomes
Median Overall Survival10.0 months (recurrent Glioblastoma)
-2% (-0.2 months)
Median Progression-Free Survival3.4 months (recurrent Glioblastoma)
-44.1% (-1.5 months)
Overall Response Rate (ORR)0% responders
+7.8% (+7.8%)
Disease Control Rate (DCR)0% controlled
+21% (+21.0%)
Secondary Benefits
Karnofsky Performance Status (KPS)70/100
+5% (+3.5 points)
Corticosteroid Dose4 mg Dexamethasone/day
-25% (-1 mg/day)
Neurological Symptom Burden (EORTC QLQ-BN20)35/100
-10% (-3.5 points)
Common Side Effects
Fatigue
+25%
Rash
+15%
Diarrhea
+15%

Clinical Trial Phases:

Phase 3Phase 4