2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.12A.16 High-Dose Aumolertinib Combined Intrathecal Chemotherapy for the Treatment of EGFR-Mutated NSCLC with Leptomeningeal Metastasis

EP.12A.16 High-Dose Aumolertinib Combined Intrathecal Chemotherapy for the Treatment of EGFR-Mutated NSCLC with Leptomeningeal Metastasis

Back to course

Pdf Summary

The study explores the efficacy of high-dose Aumolertinib in combination with intrathecal chemotherapy for treating leptomeningeal metastases (LM) in non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations. LM occurs when tumor cells spread to the leptomeninges and cerebrospinal fluid, typically presenting a poor prognosis with a median survival of only 3 months. Current treatments are limited in efficacy, but previous research suggests third-generation EGFR-TKIs can extend progression-free survival.<br /><br />Five patients with L858R EGFR-mutated NSCLC were treated with Aumolertinib (165mg orally, daily) and intrathecal pemetrexed chemotherapy. Variations in pemetrexed dosing were based on patient tolerance across three patient groups. They also received maintenance therapy every four weeks. The median treatment duration was 10 months.<br /><br />The therapy achieved a 100% intracranial objective response rate (ORR) and an overall disease control rate (DCR) of 100%. Median Eastern Cooperative Oncology Group Performance Status (ECOG PS) improved significantly from a score of 3 to 1 post-treatment. LM-related symptoms improved markedly after 3 weeks, and MRI results showed significant reduction in LM lesions after 6 weeks, including one patient's complete intracranial response.<br /><br />Treatment-related adverse events (TRAEs) were reported by all participants, with most being chemotherapy-related. Two patients experienced grade 3 TRAEs, such as leukopenia and anemia, but none experienced grade 4 TRAEs. The study concludes that Aumolertinib combined with Ommaya reservoir intrathecal chemotherapy offers promising efficacy with controllable side effects, improving patient quality of life. However, long-term follow-up and further large-scale studies are recommended to substantiate these findings and optimize treatment strategies.

Asset Subtitle

Wei Wang

Meta Tag

Speaker Wei Wang

Topic Metastatic Non-small Cell Lung Cancer – Targeted Therapy

Keywords

Aumolertinib

intrathecal chemotherapy

leptomeningeal metastases

non-small cell lung cancer

EGFR mutations

L858R

EGFR-TKIs

intracranial response

treatment-related adverse events

Ommaya reservoir