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What is your preferred first line treatment approach for a patient with PDL-1 high (>50%) NSCLC presenting with CNS mets?

If a patient is asymptomatic at presentation, how do you incorporate local treatment options (RT/surgery) and when?
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What factors would prompt you to use chemo+IO combinations vs IO immunotherapy alone?

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2 Answers
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Medical Oncology · Karmanos Cancer Institute, Wayne State University
Answered on

The treatment decision and sequencing in patients with brain metastasis from non-oligometastatic NSCLC with high PD-L1 expression and no traditional actionable genomic alterations depend on size and location of brain mets as well as associated symptoms.

Based on data from several prospective and retr...

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Medical Oncology · University of Colorado Cancer Center
Answered on
Pembrolizumab, if asymptomatic. SBRT in addition, if symptomatic.

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