WCLC 2025 - Posters & ePosters-EP.09.14 Efficacy and Safety of Intrathecal Pemetrexed in NSCLC Patients With Leptomeningeal Metastases: A Retrospective Study

EP.09.14 Efficacy and Safety of Intrathecal Pemetrexed in NSCLC Patients With Leptomeningeal Metastases: A Retrospective Study

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This retrospective study from the Department of Geriatric Oncology at Nanjing Drum Tower Hospital investigates the efficacy and safety of intrathecal pemetrexed (IP) in treating leptomeningeal metastases (LM) in non-small cell lung cancer (NSCLC) patients. The primary objectives were to evaluate IP’s therapeutic benefits and tolerability, identify prognostic biomarkers, and assess the impact of combining IP with bevacizumab, an anti-angiogenic agent.<br /><br />Results demonstrated that IP treatment led to improved median overall survival (OS) and progression-free survival (PFS) in NSCLC patients with LM, as illustrated by provided survival curves. MRI imaging comparisons before and after treatment showed notable reductions in LM lesions, underscoring the antitumor activity of the regimen. The addition of bevacizumab appeared to enhance these effects, suggesting a synergistic interaction that potentially improves clinical outcomes beyond IP alone.<br /><br />Importantly, the toxicity profile of intrathecal pemetrexed was manageable, with adverse effects not significantly limiting treatment. The study’s flow diagram outlined patient selection and treatment protocols, ensuring clarity in methodology. While the retrospective nature limits causal inference, findings indicate that IP, especially when combined with bevacizumab, offers a promising therapeutic avenue for managing LM in NSCLC patients, a condition with historically poor prognosis and limited treatment options.<br /><br />In conclusion, intrathecal pemetrexed shows meaningful efficacy and safety in NSCLC leptomeningeal metastases, and its combination with bevacizumab warrants further prospective investigation to validate and optimize this therapeutic strategy.

Asset Subtitle

Tianli Zhang

Meta Tag

Speaker Tianli Zhang

Topic Metastatic Non-small Cell Lung Cancer – Local Therapies

Keywords

intrathecal pemetrexed

leptomeningeal metastases

non-small cell lung cancer

bevacizumab

overall survival

progression-free survival

MRI imaging

toxicity profile

retrospective study

prognostic biomarkers