Guideline Recommendations and Imaging for Detection of Brain Metastasis

Panelists discuss how current NCCN guidelines emphasize the individualized treatment of patients with stable brain metastases, integrating systemic and local therapies based on disease characteristics and symptom burden. They reaffirm that both osimertinib and amivantamab–lazertinib demonstrate strong central nervous system (CNS) activity, making them preferred systemic options when intracranial control is paramount.

The discussion extends to imaging strategies, where baseline brain MRI and regular follow-up scans are considered crucial for monitoring CNS response. Panelists note that early and frequent imaging not only provides reassurance regarding drug efficacy but also enables timely identification of resistance or progression, mirroring the design of pivotal trials like MARIPOSA.

Over time, imaging intervals may be extended once stability is achieved, but consistent surveillance remains a key aspect of care. The panel agrees that structured CNS monitoring supports informed treatment adjustments and reinforces confidence in therapy durability.