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?

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...

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.

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.

No.