In conclusion, upfront use of next-generation EGFR TKIs and ALK TKIs in patients with EGFR-mutant and ALK-rearranged NSCLC with brain metastases is of value in multifocal, large-volume, and symptomatic intracranial tumors; their use in patients with symptomatic CNS metastases is associated with reasonable intracranial activity and symptomatic improvement.