2023 World Conference on Lung Cancer (Posters)-EP12.01. Aumolertinib Combination Therapy for EGFR-Mutant NSCLC Patients with Refractory Leptomeningeal Metastasis Following Osimertinib Failure

EP12.01. Aumolertinib Combination Therapy for EGFR-Mutant NSCLC Patients with Refractory Leptomeningeal Metastasis Following Osimertinib Failure - PDF(Slides)

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This study aimed to analyze the clinical efficacy of aumolertinib dosing modifications in combination with intraventricular chemotherapy for patients with refractory leptomeningeal metastasis (LM) after osimertinib failure. Leptomeningeal metastases have a poor prognosis in NSCLC, and real-world experience shows that the survival time of EGFR-mutant (EGFRm) NSCLC patients with LM doesn't exceed 4 weeks after osimertinib failure. A previous study showed that aumolertinib, a novel third-generation EGFR-TKI, in combination with bevacizumab is effective for LM. The study design included primary endpoints of progression-free survival (PFS) and overall survival (OS), as well as exploratory endpoints such as cranial enhanced magnetic resonance imaging (MRI) scans and cerebrospinal fluid (CSF) CEA levels. The study included 9 patients with EGFR mutations and LM. The median PFS and OS were 11 months and 14 months, respectively. Subgroup analysis showed a median PFS of 7 months for EGFRm NSCLC with concurrent TP53 mutations. MRI scans showed a reduction or disappearance of LM lesions in patients after 2 months of combination therapy. CSF CEA levels also decreased significantly after 2 months of therapy. One patient achieved a sustained clinical response for 15 months. This is the first report indicating that aumolertinib rechallenge strategies, such as dosing double combined with intraventricular chemotherapy, may improve clinical outcomes for EGFRm NSCLC patients with refractory LM after osimertinib failure. The combination regimen is characterized by a rapid onset of action and a long duration of remission.

Asset Subtitle

Shencun Fang

Meta Tag

Speaker Shencun Fang

Topic Metastatic NSCLC: Targeted Therapy - EGFR/HER2

Keywords

clinical efficacy

aumolertinib dosing modifications

intraventricular chemotherapy

refractory leptomeningeal metastasis

osimertinib failure

EGFR-mutant NSCLC

progression-free survival

overall survival

cranial enhanced magnetic resonance imaging

cerebrospinal fluid CEA levels