Do you ever start immunotherapy along with WBRT in patients with PDL1 >50% metastatic NSCLC with significant visceral tumor burden in addition to symptomatic brain mets?
Answer from: Medical Oncologist at Academic Institution
The general rule in the era of chemotherapy has been to hold concurrent therapy in the context of palliative radiation--in particular whole brain radiation--due to added side effects. These principles have shifted to some extent in the context of targeted therapies and checkpoint inhibitors as exper...
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Answer from: Medical Oncologist at Academic Institution
Yes, often. I see no contraindication to administering both together. If we can, we try to avoid WBRT, focusing instead on SRS to larger, more symptomatic CNS lesions, particularly since we have observed responses in the CNS with CPIs alone.
Answer from: Medical Oncologist at Community Practice
I do - however, I look for every reason in the world to avoid WBRT. If there is a way to address using a selected approach, I will do that every time. WBRT (in my opinion) is a measure of last resort these days. I do not have an issue with giving concurrently if I had to do.
Comments
Radiation Oncologist at Quillen VA Medical Center
While you are, of course, entitled to your opinion...
While you are, of course, entitled to your opinion...
Radiation Oncologist at West Virginia University
I entirely agree with Dr. @Andrew T. Turrisi on th...
I entirely agree with Dr. @Andrew T. Turrisi on th...
Radiation Oncologist at Jacob E Locke MD PA
The patient isn't benefitting from SRS but the acc...
The patient isn't benefitting from SRS but the acc...
Answer from: Medical Oncologist at Community Practice
No.