2022 World Conference on Lung Cancer (ePosters)-EP08.02-039. An Effective Treatment for EGFR-mutated Lung Adenocarcinoma with Symptomatic Leptomeningeal Metastases Using Aumolertinib

EP08.02-039. An Effective Treatment for EGFR-mutated Lung Adenocarcinoma with Symptomatic Leptomeningeal Metastases Using Aumolertinib

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This case report discusses the use of aumolertinib, a third-generation EGFR tyrosine kinase inhibitor (TKI), in the treatment of a patient with EGFR-mutant lung adenocarcinoma and symptomatic leptomeningeal metastases. Leptomeningeal metastases are a common and serious complication of EGFR-mutant non-small cell lung cancer (NSCLC). Aumolertinib has shown good penetration into the central nervous system (CNS) and a favorable safety profile in clinical trials.<br /><br />The patient in this case was a 53-year-old female with no history of smoking. She was diagnosed with stage B lung adenocarcinoma with leptomeningeal, mediastinal lymph node, liver, and multiple bone metastases. The presence of an EGFR 19-del mutation was confirmed through peripheral blood and cerebrospinal fluid (CSF) cell-free DNA analysis.<br /><br />The patient initially presented with severe headache and projectile vomiting, along with a lumbar puncture pressure of over 320mmH2O. She had a poor performance status (ECOG PS 4) at baseline, but after three days of taking aumolertinib, her symptoms improved and she was able to tolerate a liquid diet. After six days, her headache improved significantly and she continued taking aumolertinib at a reduced dose of 110mg/d. After 10 days, she only experienced a slight headache and was able to eat normally. The lumbar puncture pressure dropped to 120mmH2O after 12 days, and her performance status improved to ECOG PS 1.<br /><br />The patient was also treated with bevacizumab every three weeks. The lung and intracranial lesions both showed a partial response, and the progression-free survival (PFS) was 15 months.<br /><br />This case demonstrated the safety and effectiveness of aumolertinib in treating CNS metastases in NSCLC patients, particularly those with poor performance status and severe symptoms of leptomeningeal metastases. It also highlighted the use of fluid biopsy for molecular diagnosis and guiding treatment decisions. Overall, aumolertinib provided a practical strategy for rescuing targeted therapy in patients with catastrophic symptoms of leptomeningeal metastases.

Asset Subtitle

Xinyong Zhang

Meta Tag

Speaker Xinyong Zhang

Topic Metastatic Non-small Cell Lung Cancer - Molecular Targeted Treatments

Keywords

aumolertinib

EGFR tyrosine kinase inhibitor

lung adenocarcinoma

leptomeningeal metastases

non-small cell lung cancer

central nervous system

EGFR mutation

peripheral blood

cerebrospinal fluid

performance status