Abstract
Brain metastases account for the majority of malignant brain tumors and as newer cancer treatments improve patient survival, the reported incidence of brain metastases is increasing. Lung cancer is the most frequent origin of metastases to the brain, and this diagnosis is associated with significant morbidity as well as decreased quality of life and a worse prognosis. The treatment for brain metastases in NSCLC has historically been local therapy, either surgery or radiation, as many chemotherapies have limited efficacy in the brain. These strategies are highly effective but can be a source of morbidity themselves. Newer systemic therapies, including targeted small molecule drugs and immunotherapy, have shown promise in treating NSCLC associated CNS disease either alone or in combination with local therapies. Increasing evidence for this strategy is accumulating as more clinical trials allow the inclusion of patients with untreated asymptomatic brain metastases. This chapter summarizes the current use of systemic therapy in the treatment of brain metastases in NSCLC.
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