Ex Vivo Drug Response Evaluation for Next Generation Care of Brain Metastases

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 physicianjudgement. The number of previous lines of therapies is not limited.

• Patients with a tumor with a targetable oncogenic driver mutation should havealready 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 brainmetastasis has been histologically confirmed on the sample obtained during thesurgery performed after signing the informed consent form for the trial.

• Any type of primary cancer is allowed: breast cancer, lung cancer, melanoma, othercancers. Patients may have several primary cancers.

• Patients must have adequate bone marrow, renal and hepatic function documented atscreening before surgery

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

• Patients must have the ability to understand the requirements of the study, providewritten informed consent and authorization of use and disclosure of protected healthinformation, and agree to abide by the study restrictions and return for therequired assessments.

• Written informed consent for study participation must be signed and dated by thepatient 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 forrequiring whole brain radiotherapy after surgery. Focal brain radiotherapy aftersurgery is allowed.

• Judgement by the investigator that the patient is unlikely to comply with studyprocedures, 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 tothe first treatment initiated during the study.

• Sexually active males and females of childbearing potential who are not willing touse an effective contraceptive method during the study. Male participants who do notagree not to donate sperm.