
Central nervous system (CNS) metastases remain a major clinical challenge in the management of non–small cell lung cancer (NSCLC), particularly in tumors harboring oncogenic drivers such as EGFR mutations and ALK rearrangements.
At the 2025 World Conference on Lung Cancer (WCLC) in Barcelona, Spain, Helena Yu, MD, attending physician at Memorial Hospital and research director at Thoracic Oncology Service at Memorial Sloan Kettering (MSK) Cancer Center, presented a comprehensive overview of the biology, current treatment options, and ongoing challenges associated with CNS involvement in EGFR-mutant NSCLC. Yu highlighted recent clinical insights, novel therapeutic approaches, and evolving strategies for radiation use, while also identifying key areas for future research.
Key Takeaways
- CNS metastases in EGFR-mutant NSCLC are prevalent and worsen prognosis, especially with acquired progression during treatment.
- Amivantamab plus lazertinib shows promising CNS activity, but current response criteria may not capture all clinical benefits.
- Proton craniospinal irradiation improves survival in leptomeningeal metastases, potentially setting a new standard of care.
- Novel therapeutic strategies, such as intrathecal iron chelation, are being explored to address leptomeningeal metastases.
- Future research should focus on epigenetic drivers, CNS-specific trial cohorts, and improved diagnostic and response assessment strategies.
Read full article: https://www.ajmc.com/view/cns-metastases-in-egfr-mutant-nsclc-emerging-therapeutic-strategies-and-ongoing-challenges







