• J Bradley Elder, Brian V Nahed, Mark E Linskey, and Jeffrey J Olson.
• Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
• Neurosurgery. 2019 Mar 1; 84 (3): E201-E203.

QuestionWhat evidence is available regarding emerging and investigational treatment options for metastatic brain tumors?Target PopulationAdult patients with brain metastases.RecommendationsInterstitial ModalitiesThere is insufficient evidence to make a recommendation regarding the routine use of existing local therapies, such as interstitial chemotherapy, brachytherapy, or other local modalities, aside from their use in approved clinical trials.Immune ModulatorsThere is insufficient evidence to make a recommendation regarding the use of immune therapy for brain metastases.Molecular Targeted AgentsLevel 1: The use of afatinib is not recommended in patients with brain metastasis due to breast cancer.There is insufficient evidence to make recommendations regarding: the use of epidermal growth factor receptor inhibitors erlotinib and gefitinib in patients with brain metastasis due to nonsmall cell lung cancerthe use of BRAF inhibitors dabrafenib and vemurafenib in the treatment of patients with brain metastases due to metastatic melanomathe use of HER2 agents trastuzumab and lapatinib to treat patients with brain metastases due to metastatic breast cancerthe use of vascular endothelial growth factor agents bevacizumab, sunitinib, and sorafenib in the treatment of patients with solid tumor brain metastases.The full guideline can be found at: https://www.cns.org/guidelines/guidelines-treatment-adults-metastatic-brain-tumors/chapter_9.Copyright © 2019 by the Congress of Neurological Surgeons.

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