New phase 2 data show favorable cognitive outcomes with Leksell Gamma Knife in patients with up to 50 brain metastases

The study used Gamma Knife radiosurgery together with Sunnybrook’s Spatially Partitioned Adaptive Radiosurgery technique, known as SPARE, an approach developed for patients with multiple brain metastases. Results showed favorable memory performance two months after treatment. Investigators also reported no difference in time to meaningful cognitive decline between patients with 21 to 50 metastases and those with 5 to 20 metastases.

Brain metastases are among the most common intracranial tumors, and as patients live longer with advanced disease, the need for precise and efficient treatment options continues to grow. Leksell Gamma Knife stereotactic radiosurgery is designed to treat visible tumors while limiting radiation exposure to surrounding healthy brain tissue, helping support the goal of preserving cognitive function and quality of life.

“Gamma Knife radiosurgery has long been associated with exceptional precision in the brain,” says John Christodouleas, MD, MPH, Head of Medical Affairs and Partner Research at Elekta. “These findings are important because they add to the clinical evidence supporting focal treatment approaches for patients with multiple brain metastases, including patients with higher numbers of metastases than have traditionally been treated with stereotactic radiosurgery.”

“We are encouraged by our findings showing SRS is associated with sustained memory performance at the two-month mark after treatment, despite treating up to 50 brain tumors in a single patient,” says Dr. Arjun Sahgal, senior author of the abstract and senior scientist with the Odette Cancer Research Program at Sunnybrook Research Institute. “While further comparative investigations are needed, the demonstration of sustained cognitive function suggests expansion of the indication to focally radiate patients with multiple metastases and avoid the harmful effects of whole brain radiation.”

According to the investigators, this is the first clinical trial to report outcomes for patients with up to 50 brain metastases treated with stereotactic radiosurgery. The findings support the continued evolution of Gamma Knife radiosurgery as a treatment approach for selected patients who may otherwise be considered for whole brain radiation, which can be associated with a risk of detrimental cognitive side effects.

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