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For patients with central nervous system metastases at diagnosis but without severe mass effects and in whom a targetable alteration is found for which a central nervous system-penetrant TKI is available, potential therapeutic strategies include TKI treatment prior to radiotherapy or surgical resection of brain lesions given the high intracranial efficacy of these drugs in clinical trials

Sleeplessness is the most common side effect, presented either in the form of having a hard time falling asleep or awakening very early in the morning and not getting back to sleep

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