Brain metastases are a frequent complication in patients with lung cancer and a significant cause of morbidity and mortality. The prognosis of these patients is poor. Medical therapies for brain metastases are neither well-studied nor established. This review analyzes the impact of medical treatment on survival by reviewing recent articles of the management of brain metastases from lung cancer patients. Chemotherapy for brain metastases from lung cancer is effective for both small cell and non-small cell lung cancer. Since brain metastases are part of systemic progression, chemotherapy should always be considered for the therapeutic management of brain metastases. Available data and response rates in lung cancer patients indicated that medical treatment for the management of brain metastases should be part of a multimodality treatment.