How would you treat a patient with metastatic NSCLC with repeated episodes of CNS brain metastases but otherwise with good systemic disease control on maintenance therapy?

The answer to this question would have been easy 10-20 years ago - you would give whole brain radiation. With the routine incorporation of SRS for brain mets and better systemic therapies, the trend over the last few years has been to go away from whole-brain radiation. Whole-brain radiation has bee...

I have had a few such patients recently, unfortunately. With systemic disease controlled outside of the brain, my approach has generally been to consider whole brain radiation. If this is refused or declined then I would change systemic therapy to include bevacizumab. Safety previously has been repo...