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Would you change systemic therapy in a patient with SCLC with stable systemic disease but CNS progression?
This particular patient previously progressed on platinum and is currently on lurbinectedin for >18 months. She had CR on PET. Now presents with a third CNS progression (previous CNS treatment with SRS, then WBRT, plan for SRS with current lesions). Should I change lurbinectedin if systemic disease is well controlled? Or should I consider changing to an agent with potentially better CNS penetration?
Answer from: Medical Oncologist at Academic Institution
Since the patient has well-controlled extracranial disease, I would continue lurbinectedin. As the new intracranial lesions are potentially treatable with SRS, I would favor that approach for this patient.
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