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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

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Case Follow-up
She starts Dato-DXd 6 mg/kg IV every 3 weeks. After 2 cycles, CT shows improvement in her systemic disease, and brain MRI also shows decreased size of the brain metastases, consistent with emerging data suggesting intracranial activity of Dato-DXd in NSCLC brain metastases.

During treatment, she also develops grade 1 stomatitis that is managed with intensified oral supportive care, including increased use of steroid-containing mouthwash, while she continues therapy without dose interruption.

Between cycles 7 and 8 of Dato-DXd, she develops increasing cough, wheeze, and shortness of breath. She has no fever and no sick contacts. Her oxygen saturation is 93%, down from a baseline of 98%. On examination, she has fine crackles on the left side and mild wheezing. CT chest shows new multifocal ground-glass opacities in the left upper lobe, lingula, and right lower lobe. What is the most appropriate next step in her management now?