2023 World Conference on Lung Cancer (Posters)-EP12.01. Long Survival in LM NSCLC Treated with Aumolertinib and Metronomic Intrathecal Pemetrexed under Dynamic Detection of CSF ctDNA

EP12.01. Long Survival in LM NSCLC Treated with Aumolertinib and Metronomic Intrathecal Pemetrexed under Dynamic Detection of CSF ctDNA - PDF(Abstract)

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A case report presented at the World Conference on Lung Cancer in 2023 demonstrated the effectiveness of a combination therapy in the treatment of leptomeningeal metastases (LM) in non-small cell lung cancer (NSCLC) patients. Leptomeningeal metastases is a condition characterized by poor treatment efficacy and short survival rates. However, the use of cerebrospinal fluid (CSF) circulating tumor DNA (ctDNA) testing has provided better insights into the disease and its treatment. <br /><br />In this particular case, a 58-year-old female patient with NSCLC was diagnosed with LM through CSF ctDNA testing, which revealed an EGFR L858R mutation. The patient was then treated with aumolertinib, a third-generation EGFR-TKI with better blood-brain barrier penetration. Additionally, metronomic intrathecal pemetrexed was administered under dynamic monitoring of CSF ctDNA to further accelerate remission of the intracranial lesions. The patient achieved long-term disease control and remained under close follow-up.<br /><br />The report emphasizes the importance of CSF ctDNA testing in guiding the clinical treatment of intracranial lesions and understanding the situation of such lesions. The combination therapy of aumolertinib and metronomic intrathecal pemetrexed improved the treatment efficacy of LM, leading to a long survival time of more than 25 months and a good quality of life for the patient.<br /><br />Overall, this case demonstrates the potential of CSF ctDNA testing and the use of targeted therapies in the management of NSCLC with leptomeningeal metastases. Despite its somewhat invasive nature, lumbar puncture for CSF ctDNA detection is considered necessary for a better understanding of intracranial lesions and to provide optimal treatment.

Asset Subtitle

Zhao Dai

Meta Tag

Speaker Zhao Dai

Topic Metastatic NSCLC: Targeted Therapy - EGFR/HER2

Keywords

World Conference on Lung Cancer

leptomeningeal metastases

non-small cell lung cancer

cerebrospinal fluid

circulating tumor DNA

EGFR L858R mutation

aumolertinib

metronomic intrathecal pemetrexed

intracranial lesions

CSF ctDNA testing