Optimizing Outcomes for Central Nervous System Metastases in EGFR-Mutated Advanced Non-small Cell Lung Cancer

This episode has been funded by AstraZeneca and is intended for healthcare professionals. All content has been developed independently by AMJ, and AstraZeneca has had no influence over the content of this podcast. The views expressed are those of the participating experts and do not necessarily reflect the views of AMJ or AstraZeneca. This material is intended for educational and scientific exchange purposes only. Thoracic medical oncologist Julia Rotow and neuro-oncologist David O. Kamson discuss how they manage central nervous system metastases in EGFR-mutated advanced non-small cell lung cancer. They begin with brain metastases found at diagnosis, and how the current frontline regimens have changed the decision between systemic therapy with MRI surveillance, upfront stereotactic radiosurgery, and, for some patients, both. They also explain where whole brain radiotherapy now sits in their own practice. The speakers then discuss leptomeningeal disease: why it is often recognized late, what they add to the standard workup, and the symptoms that make them worry about hydrocephalus and cauda equina involvement. They review systemic and local options after progression on a third-generation tyrosine kinase inhibitor, and close with where they each see the biggest gap in current central nervous system management. Speakers David O. Kamson, Johns Hopkins University, Baltimore, Maryland, USA Julia Rotow, Dana-Farber Cancer Institute, Boston, Massachusetts, USA