2023 World Conference on Lung Cancer (Posters)-EP12.01. High-Dose Aumolertinib Combined Intrathecal Chemotherapy for LM from EGFR-Mutated NSCLC with Meningeal Symptoms as the First Symptom

EP12.01. High-Dose Aumolertinib Combined Intrathecal Chemotherapy for LM from EGFR-Mutated NSCLC with Meningeal Symptoms as the First Symptom - PDF(Abstract)

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This is a summary of a case report presented at WCLC 2023 on the topic of metastatic non-small cell lung cancer (NSCLC) with leptomeningeal metastasis (LM). LM is a serious complication of NSCLC with limited treatment options and poor prognosis. The case describes a 52-year-old female patient with violent meningeal symptoms as the first symptom, including explosive headaches and vomiting. The patient was diagnosed with stage IV lung adenocarcinoma with multiple leptomeningeal, lymph node, and bone metastases. Given the significant symptoms, the patient was treated with high-dose aumolertinib combined with Ommaya reservoir intrathecal chemotherapy. This treatment strategy led to the relief of intracranial hypertension and improvement in symptoms. Further testing showed the presence of EGFR mutation in both cerebrospinal fluid (CSF) and blood. Imaging exams showed partial remission of lung lesions and complete remission of LM lesions. However, the patient experienced an elevated level of carcinoembryonic antigen (CEA) in the CSF, and pemetrexed was implemented to enhance local control of LM. The patient is currently receiving aumolertinib treatment and being followed up for clinical updates. This case demonstrates the potential positive effect of high-dose aumolertinib combined with intrathecal chemotherapy on LM from NSCLC with violent meningeal symptoms and provides a practical strategy for the rescue therapy of severe meningeal symptoms in leptomeningeal metastases.

Asset Subtitle

Wei Wang

Meta Tag

Speaker Wei Wang

Topic Metastatic NSCLC: Targeted Therapy - EGFR/HER2

Keywords

metastatic non-small cell lung cancer

leptomeningeal metastasis

NSCLC

complication

violent meningeal symptoms

high-dose aumolertinib

intrathecal chemotherapy

EGFR mutation

partial remission

carcinoembryonic antigen