Aside from radiation, what is your approach to patients with EGFR-mutated or ALK-translocated metastatic NSCLC who have systemic disease control but fail in the CNS?
Do you increase the dosage of the TKI or switch to a different generation TKI? How does your answer differ for EGFR vs. ALK, and for discrete brain metastases vs. leptomeningeal disease?
Answer from: Medical Oncologist at Academic Institution
While there are systemic agents that have brain penetration, my most standard treatment remains radiotherapy. That said, the questions specifically asked about non-XRT options.
I do think about parenchymal brain metastases and LMD a bit differently. For LMD in EGFR-mutated NSCLC, I do sometimes use...
Comments
Radiation Oncologist at Yale School of Medicine For patients with ALK-translocated NSCLC and asymp...
Medical Oncologist at Kettering Cancer Center What systemic treatment would you offer to a patie...
Answer from: Medical Oncologist at Academic Institution
I agree with Dr. @Weiss that a discussion with my Radiation Oncology colleagues for considering radiotherapy of some form will typically be my first, second, and third choice in this setting. This question is asking about systemic therapy choices for patients with EGFR and ALK mutant NSCLC who have ...
For patients with ALK-translocated NSCLC and asymp...
What systemic treatment would you offer to a patie...