Would you offer WBRT to a patient with ES-SCLC with improving brain mets on immunotherapy?

The answer to this question arises more from the domains of personal opinion and anecdotal experience rather than a strong evidence basis. The study establishing the value of atezolizumab in this setting (N Engl J Med 2018) does not provide data specific to informing a management approach.

At my own ...

I do, but there is not high level evidence to guide therapy.

In IMpower 133, patients with untreated brain metastases were not eligible, so that dataset does not guide us. CASPIAN did allow patients with untreated brain metastases, but only 10% of patients had CNS metastases, and we do not know how m...