Systemic therapy in patients with NSCLC with brain metastasis: the emerging role of immunotherapy

Brain metastasis (BM) is very common in advanced non-small cell lung cancer (NSCLC) patients. The development of BM remains a serious complication associated with significant morbidity and mortality. The traditional approach has been largely focusing on local therapy with surgery and/or radiation. New approaches to treat BM in NSCLC are urgently needed to offer safe and effective therapy as well as to preserve neurocognitive function. There has been significant progress in development of systemic therapies to treat advanced NSCLC in recent years. Targeted therapy has been gradually incorporated into clinical practice to manage NSCLC with BM. Immunotherapy (IO) has revolutionized our treatment paradigm to manage advanced NSCLC. In this review we outline the systemic options for NSCLC-related BM and discuss IO in NSCLC. Finally, we describe the available data and future perspective to support the use of IO in NSCLC patients with BM.