Initial management of brain metastases from NSCLC lacking a targetable driver mutation

For patients who are frail or prefer to avoid aggressive treatment, supportive care alone is an alternative option.

This algorithm illustrates the initial management of patients with brain metastases from NSCLC without mutations in a targetable driver (eg, ALK, ROS1, EGFR). NSCLC with one of these mutations is managed differently.

NSCLC: non-small cell lung cancer; ALK: anaplastic lymphoma kinase; ROS1: c-ROS oncogene 1; EGFR: epidermal growth factor receptor; SRS: stereotactic radiosurgery; WBRT: whole-brain radiation therapy.

* For patients with a solitary brain metastasis, surgical resection may improve survival and may be an alternative option. Refer to the UpToDate discussion on oligometastatic disease and brain metastases.

¶ SRS is preferred over WBRT, when feasible. SRS versus WBRT is discussed in detail in the UpToDate overview discussion on treatment of brain metastases.

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خرید پکیج

Initial management of brain metastases from NSCLC lacking a targetable driver mutation