Clinical Trial Finder

Inclusion Criteria:

• - Patients must be 18 years or older on the day of signing the informed consent, female or male.

• - Patients must have a Karnofsky performance status of 60 or more.

• - Patients must have limited systemic therapeutic options as per treating physician judgement.

The number of previous lines of therapies is not limited.

• - Patients with a tumor with a targetable oncogenic driver mutation should have already been treated with a targeted agent and options must have been exhausted.

• - Patients must have a clinical indication for surgery for probable brain metastasis.

• - Patients will be considered eligible for the study only if the diagnosis of brain metastasis has been histologically confirmed on the sample obtained during the surgery performed after signing the informed consent form for the trial.

• - Any type of primary cancer is allowed: breast cancer, lung cancer, melanoma, other cancers.

Patients may have several primary cancers.

• - Patients must have adequate bone marrow, renal and hepatic function documented at screening before surgery.

• - Women of childbearing potential, including women who had their last menstruation in the last 2 years, must have a negative urinary or serum pregnancy test.

• - Patients must have the ability to understand the requirements of the study, provide written informed consent and authorization of use and disclosure of protected health information, and agree to abide by the study restrictions and return for the required assessments.

• - Written informed consent for study participation must be signed and dated by the patient and the investigator prior to any study-related intervention.

Exclusion Criteria:

• - Patients with rapidly progressive systemic disease.

• - Patients with inability to undergo brain MRI evaluation.

• - Patients with progressive parenchymal brain metastases with an indication for requiring whole brain radiotherapy after surgery.

Focal brain radiotherapy after surgery is allowed.

• - Judgement by the investigator that the patient is unlikely to comply with study procedures, restrictions and requirements.

• - Intention to become pregnant during the course of the study.

• - Female who are pregnant.

• - Female who are breastfeeding and who do not agree to discontinue nursing prior to the first treatment initiated during the study.

• - Sexually active males and females of childbearing potential who are not willing to use an effective contraceptive method during the study.

Male participants who do not agree not to donate sperm.

Arms

Experimental: Arm 1: experimental arm, Pharmacoscopy-guided treatment

Arm 1 (experimental arm): Pharmacoscopy-guided treatment will be prescribed by the investigator according to the results of the analysis (relevant on-target effect) and per drug prescription guidelines.

Active Comparator: Arm 2: control arm

For patients randomized to the control arm, no pharmacoscopy analysis will be performed.

Interventions

Device: - Pharmacoscopy 1.0

Pharmacoscopy is currently an academically developed platform. The study is designed to investigate the clinical performance of this academic platform. In the interventional arm, the best candidate agent defined by pharmascopy will be considered to guide the therapeutic decision for each patient.

Other: - Control

The next systemic treatment after surgery will be discussed, with the investigator and at the tumor board, considering also standard histopathological and molecular analysis, including next generation sequencing, molecular profiling analysis and previous treatments received