I have posted this question before but don't think I got a satisfactory answer.
Under normal circumstances it usually is suggested to get the maximum benefit out of first line TKI treatment even when slight progression is observed , before moving on to the next generation drug.
If one was diagnosed with 9 brain mets right at the start, you already have a disadvantage compared to a patient that has no CNS disease at time of diagnosis.
I would assume the danger of developing Lepto is increased under those circumstances?
Would it be feasible to move from Tarceva to Tagrisso sooner than usually recommended , to delay the onset of lepto, even if that means that one will run out of the most effective agents sooner ?
I think someone with extensive CNS disease does not have the luxury to be patient with Tarceva in the face of slight progression, even when the CNS mets are " controlled " at this time.
Thanks , and please excuse my repetitive question.