2023 World Conference on Lung Cancer (Posters)-EP12.02. Frequency and Outcomes of Leptomeningeal Metastases in Patients with Fusion-Positive Lung Cancers

EP12.02. Frequency and Outcomes of Leptomeningeal Metastases in Patients with Fusion-Positive Lung Cancers - PDF(Slides)

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Leptomeningeal metastases (LM) in fusion-positive lung cancers have traditionally been associated with poor prognosis and short survival. However, the advent of targeted therapies has improved outcomes for these patients. This study aimed to evaluate the frequency and outcomes of LM in fusion-positive lung cancers, specifically those with ALK, ROS1, RET, or NTRK gene fusions.<br /><br />Data was collected from patients with fusion-positive lung cancers between January 2014 and March 2023 using next generation sequencing. LM was classified according to guidelines, and clinical data including demographics, tumor characteristics, and treatment history were analyzed.<br /><br />Among the patients, 8% were found to have LM, with the majority developing LM while on treatment. The most commonly used tyrosine kinase inhibitors (TKIs) for treating LM were lorlatinib, alectinib, and selpercatinib. Median survival from LM detection ranged from 8 months for ROS1 fusions to 30 months for ALK fusions. Switching to another targeted therapy and craniospinal irradiation were associated with responses in LM.<br /><br />Multidisciplinary care was identified as crucial for optimal management of LM. Genetic profiling revealed a range of alterations in fusion-positive lung cancers, including TP53, CDKN2A/B, and PIK3CA mutations.<br /><br />In conclusion, this study found that LM occurs in approximately 8% of fusion-positive lung cancer patients, with most cases developing while on treatment. The use of TKIs and craniospinal irradiation can lead to responses in LM. Median survival varies depending on the fusion type. Multidisciplinary care is important for managing LM effectively.

Asset Subtitle

Monica Chen

Meta Tag

Speaker Monica Chen

Topic Metastatic NSCLC: Targeted Therapy - FUSIONS

Keywords

Leptomeningeal metastases

fusion-positive lung cancers

prognosis

survival

targeted therapies

ALK gene fusions

ROS1 gene fusions

RET gene fusions

NTRK gene fusions

next generation sequencing