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CNS metastases in EGFR-mut pts
•
In pts with EGFR-mut, incidence of brain metastases 45%, LM 20%
•
Less use of WBRT, long term toxicity, clear need for active small molecules at brain
•
Treatment of brain metastases during EGFRTKI:
If BM treatable with stereotactic RT and systemic disease is in PR, treat with
stereotactic RT and continue EGFR-TKI
If WBRT needed and/or patient has symptomatic systemic PD, change to 2
nd
-
generation
EGFR
inhibitor