For ALK+ patients rendered NED from oligometastatic NSCLC after resection of both lung primary and isolated CNS lesion, do you consider offering treatment with an ALK inhibitor after adjuvant chemotherapy, or do you place into surveillance?

A large proportion of patients with oligometastatic disease managed with curative intent generally relapse, either intracranially and/or extracranially. TKI therapy maybe expected to prolong disease-free/progression-free survival based on our experience with EGFR TKIs.

However, given the expected duration of therapy with a TKI and lack of definitive data of OS benefit of early treatment versus therapy initiation when clinically indicated, opting for close surveillance without additional TKI ther...

A large proportion of patients with oligometastatic disease managed with curative intent generally relapse, either intracranially and/or extracranially. In an analysis of NCDB outcomes, our group showed that NSCLC patients with synchronous brain metastases who underwent thoracic surgery and received perioperative chemotherapy had better OS compared to those who underwent surgery alone (Vedire et al., PMID 37275564). While there is inherent confounding bias in such analyses, chemotherapy administ...