Our summary
For patients with advanced non-small cell lung cancer (aNSCLC), routine testing for anaplastic lymphoma kinase (ALK) is the standard of care on account of improved survival with ALK inhibitors in ALK+ disease. Additionally, radiation therapy is the standard of care in treating NSCLC-related brain metastases (BM).
However, it is unclear to what degree novel targeted agents, including those with improved central nervous system (CNS) activity, will impact the utilization of radiation therapy. Treatment paradigms now allow for systemic targeted drugs before surgery or radiation in selected asymptomatic patients with aNSCLC with BM. This study aims to characterize the real-world use of radiation therapy for the treatment of BM in patients with ALK+ NSCLC who receive novel ALK-targeted first line therapy.
Why this matters
Given the findings of this study, physicians may be increasingly comfortable deferring upfront local therapy for BM in lieu of novel targeted agents. The appropriateness and clinical outcomes of these treatment patterns require continued study as targeted agents with CNS activity become increasingly available in the clinic.