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EGFRm NSCLC Brain Metastases

CE / CME

Management of a Patient With EGFR-Mutated NSCLC and Brain Metastases

Physician Assistants/Physician Associates: 0.50 AAPA Category 1 CME credit

Pharmacists: 0.50 contact hour (0.05 CEUs)

Physicians: maximum of 0.50 AMA PRA Category 1 Credit

Nurse Practitioners/Nurses: 0.50 Nursing contact hour

Released: May 04, 2026

Expiration: November 03, 2026

Activity

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Course Completed

For those who practice in academic or community settings, please indicate your practice setting:

How many people with non-small-cell lung cancer (NSCLC) do you provide care for in a typical month?

A patient with metastatic NSCLC and an EGFR exon 19 deletion experiences progression after first-line treatment with osimertinib and platinum-based chemotherapy. No new actionable resistance mechanism is identified. Which of the following treatment options would you recommend based on available evidence and current FDA-approved indications?

A patient with metastatic EGFR-mutated NSCLC is receiving Dato-DXd. She develops new cough, dyspnea, and mild hypoxia. CT chest reveals multifocal ground-glass opacities, and symptomatic grade 2 interstitial lung disease (ILD)/pneumonitis is suspected. Which of the following is the most appropriate management recommendation for this patient?

History
Your patient is a 74-year-old woman with metastatic NSCLC (adenocarcinoma) harboring an EGFR exon 19 deletion. She has a 15 pack-year smoking history and mild chronic obstructive pulmonary disease (COPD) managed with a rescue inhaler. Eighteen months ago, she started first-line osimertinib plus carboplatin/pemetrexed and achieved durable systemic disease control. She remains active with an Eastern Cooperative Oncology Group performance status of 1.

Current Presentation
At today’s routine restaging visit, CT of the chest/abdomen/pelvis shows progression with growth of a left upper lobe lesion, 3 new liver metastases, and a new lesion at the T4 vertebral level. In clinic, she reports increasing intensity of a left-sided temporal headache over the last 2 weeks. She has no seizures and no focal motor weakness.

What is the best next diagnostic step for this patient at this time?