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Thoracic Malignancies • Medical Oncology • NCI-CCC Tumor Board Question • University of Michigan
How would you approach the treatment of resectable NSCLC with a solitary resectable brain metastasis and no other sites of metastasis?
Would you offer adjuvant therapy post resection?
Answer from: Medical Oncologist at Academic Institution
There is a several decade history of curing NSCLC in patients presenting with a solitary CNS metastasis and with resectable lung primary. This has primarily been for patients with N0 or N1 rather than N2 disease. It is unknown whether SBRT would be equivalent to craniotomy. There is, of course, no d...
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Answer from: Medical Oncologist at Academic Institution
Our group queried the National Cancer Database to compare the outcomes based on receipt of systemic adjuvant chemotherapy after resection of lung primary in NSCLC (N0/N1) who presented with synchronous brain metastases. Data was presented at ASCO 2017 and manuscript to be submitt...
Answer from: Medical Oncologist at Community Practice
I favor resection of brain met too, not only because we do not know how surgery compares to SRS for solitary brain mets, but also to make sure we are not dealing with 2 primary tumors. The challenge would be more difficult if we are dealing with a NSCLC that carries a drivable mutation, would you us...