Grant: Project Grant

Acute ischemic stroke is due to a blockage of blood flow to the brain with often devastating outcomes. With our 2015 ESCAPE study, we helped to establish mechanical clot removal as a treatment for the obstruction of a major blood vessel, thereby greatly improving patient lives. However, around 40% of stroke patients still end up being permanently disabled or dying. Adjunct therapies increase the brain's tolerance to oxygen deprivation thereby improving outcomes after stroke. For one such therapy, Nerinetide, we demonstrated a benefit in select patients in the ESCAPE-NA1 study. With ESCAPE-NEXT, we seek to confirm these results. A main challenge of studies testing adjunct therapies is selecting patients that are most likely to benefit given the specific mechanisms of action of the drugs being tested. Magnetic resonance imaging (MRI) of the brain allows for visualization of brain damage and is already used to help choose the optimal treatment(s) for stroke patients. ESCAPE-CORE seeks to develop a novel standardized MRI protocol for use in future studies, allowing for improved therapeutic decision making/individually tailored adjunct therapies, similar to cancer treatment. We aim to characterize and validate imaging features of the extent and type of brain injury using multiple imaging timepoints up to 90 days after stroke onset, combining the use of existing MRI technologies with novel, in-house developed imaging approaches. ESCAPE-CORE will be carried out at 7 North American/European centers, bringing together world-renowned expertise in adjunct stroke treatment and deep knowledge of advanced MRI. With this study, we will help to individualize stroke treatment, thereby taking another important step towards improving our patients' lives and further establishing Canada as a world leader in advancing stroke care.