Introduction
NSCLC
BRAIN METASTASIS, BRAIN METASTASES, DISEASE, BRAIN METASTASES, SMALL CELL LUNG CANCER, NSCLC
Brain metastases occur in approximately 30% to 40% of patients with non–small cell lung cancer (NSCLC) during the course of the disease and 20% to 25% of patients with advanced NSCLC have brain metastasis at the initial diagnosis.Historically, brain metastases were treated with surgical resection, radiotherapy, and antitumor agents, either alone or in combination. For patients with metastatic NSCLC harboring Although superior efficacy of EGFR-TKIs was shown, resistance to treatment with the first-generation EGFR-TKIs developed, and their median PFS is approximately 8 to 12 months. Several strategies have been explored to improve PFS and overcome resistance, including use of next-generation EGFR-TKIs and EGFR-TKI combination treatment. The third-generation EGFR-TKI osimertinib prolonged PFS to 18 months as first-line treatment and to approximately 15 months in a subgroup of patients with brain metastases. The vascular endothelial growth factor signaling pathway is a candidate target for combination therapy; however, the efficacy of vascular endothelial growth factor treatment in patients with brain metastasis is controversial.