Do you hold osimertinib when delivering partial or whole brain 3D radiation?

I typically don't mandate holding osimertinib while administering SRS for brain metastases unless my medical or neuro-oncologist has concerns. In such cases, I might consider delaying the initiation of osimertinib for about a week. Notably, there are two prospective studies (NCT03769103 and NCT03497767) investigating the use of osimertinib with or without SRS for brain metastases. One of these trials even allows for osimeritinib to commence as early as one day post-SRS, aiming to evaluate potential toxicity concerns compared to SRS treatment alone.