高达 40% 的非小细胞肺癌 (NSCLC) 患者会发生中枢神经系统 (CNS) 转移。目前对这一晚期 NSCLC 患者亚组的治疗包括局部治疗（手术、立体定向放射外科以及较少见的全脑放射治疗）、针对致癌基因成瘾的 NSCLC 的靶向治疗（小分子，如酪氨酸激酶抑制剂和抗体-药物缀合物）和免疫检查点抑制剂（作为单一疗法或联合疗法），多种新药正在开发中。然而，鉴于大多数肺癌临床试验排除了未经治疗和/或进展性 CNS 转移的患者，或者不包括预先指定的 CNS 相关终点，因此证实这些治疗的颅内活性具有挑战性。在这里，我们回顾了非小细胞肺癌中枢神经系统转移患者的治疗进展，研究了局部治疗方案、全身治疗和多模式治疗策略。我们还考虑了治疗反应评估方面的挑战，并就晚期 NSCLC 患者中枢神经系统疾病管理的未来方向提供了想法。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Up to 40% of patients with non-small cell lung cancer (NSCLC) develop central nervous system (CNS) metastases. Current treatments for this subgroup of patients with advanced NSCLC include local therapies (surgery, stereotactic radiosurgery, and, less frequently, whole-brain radiotherapy), targeted therapies for oncogene-addicted NSCLC (small molecules, such as tyrosine kinase inhibitors, and antibody-drug conjugates), and immune checkpoint inhibitors (as monotherapy or combination therapy), with multiple new drugs in development. However, confirming the intracranial activity of these treatments has proven to be challenging, given that most lung cancer clinical trials exclude patients with untreated and/or progressing CNS metastases, or do not include prespecified CNS-related endpoints. Here we review progress in the treatment of patients with CNS metastases originating from NSCLC, examining local treatment options, systemic therapies, and multimodal therapeutic strategies. We also consider challenges regarding assessment of treatment response and provide thoughts around future directions for managing CNS disease in patients with advanced NSCLC.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.