Do you recommend prophylactic cranial irradiation for ES-SCLC patients now that immunotherapy is included in the treatment schema?  

I do not pursue PCI for most patients with extensive stage SCLC. We know the EORTC phase III study led by Ben Slotman (NEJM 2007) showed a decrease in the cumulative risk of brain metastases that translated into a survival benefit. One of the flaws of the study was the lack of baselin...

I became much less enthusiastic about recommending PCI in such patients. Would still bring it up for discussion in younger patients with excellent performance status and "oligometastatic" extensive stage, and would be willing to deliver it if patients were interested.