REMASTer: REcurrent Brain Metastases After SRS Trial

Inclusion criteria

• . Patients with radiographically proven (by gadolinium-enhanced \[Gd-\] MRI) parenchymal brain metastases from histologically confirmed non-central nervous system (CNS) cancer.
• . Patients with a "targetable", bidimensionally-measurable, intracranial lesion that is radiographically recurrent after previous treatment with SRS +/- surgery (craniotomy or LITT). To classify a lesion as radiographically progressive, the lesion must demonstrate a ≥ 25% increase in size following treatment based on the Neuro-Oncology Criteria of Tumor Response for CNS Tumors. To be "targetable" for this study, the lesion should be coverable through a planned single LITT trajectory and thus have a maximum perpendicular diameter (perpendicular to the laser trajectory) of 3 cm. An intra-operative decision to utilize two trajectories is acceptable and patient may remain on study.
• . Patient must be at least 3 months post initial SRS treatment of the target lesion
• . Target lesion must be amenable to undergo surgical biopsy and LITT treatment as determined by the treating neurosurgeon.
• . Frozen pathology diagnosis must be attainable.
• . Patient must be symptomatically stable for a minimum of 3 days prior to the procedure date on a on a max total daily steroid dose equivalent to 4mg of Dexamethasone.
• . ≥18 years of age
• . KPS ≥70

Exclusion criteria