John Gosney, BSc, MBChB, Liverpool University Hospitals NHST, UK, talks on the management of brain metastases and large cell neuroendocrine carcinoma discussed at the BTOG 2022 Summer Meeting. Although two different topics, the respective sessions carried the same message on the importance of understanding the biology in order to fulfil the requirements for managing the diseases. For example, whether the metastases has a genomic driver or is immunogenic will determine how to manage the patient. Prof. Gosney additionally talks on the controversial classification of large cell neuroendocrine carcinoma. This interview took place at the BTOG 2022 Summer Meeting congress in London.