Treatment of lung adenocarcinoma brain metastases: what is the role of radiotherapy in the age of precision medicine?

Lung cancer is the second most common type of cancer and the leading cause of cancer-related mortality (1). The discovery of oncogenic driver mutations and the development of immune checkpoint inhibitors has resulted in improved clinical outcomes for these patients. As systemic therapies continue to improve in the era of precision medicine, patients live longer and are thus at increased risk for brain metastases (2). Lung cancer, specifically non-small cell lung cancer (NSCLC), is the most common primary cancer associated with development of brain metastases with approximately 30–40% of affected patients developing brain metastases (1). Treatment of intracranial disease in this setting is multimodal and can include systemic therapy, surgery, stereotactic radiosurgery (SRS), whole brain radiotherapy (WBRT), and/or supportive care.