How would you manage a patient with EGFR mutant adenocarcinoma of the lung on erlotinib with a single site of disease progression, but otherwise well-controlled disease?

This is a point of controversy. There are multiple reasonable options to consider for such a patient:

1. Keep going with tarceva and follow the lesion carefully. The NCCN guidelines actually acknowledge this approach for asymptomatic disease.
2. Use SRS or some other locally ablative approach to destro...