WCLC 2025 - Posters & ePosters-P3.12.53 High-Dose Furmonertinib Plus Bevacizumab in EGFR-Mutant NSCLC With CNS Metastases After Resistance to Third-Generation EGFR-TKIs

P3.12.53 High-Dose Furmonertinib Plus Bevacizumab in EGFR-Mutant NSCLC With CNS Metastases After Resistance to Third-Generation EGFR-TKIs

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This retrospective single-center study evaluated the efficacy and safety of high-dose furmonertinib (160 mg daily), a third-generation EGFR tyrosine kinase inhibitor (TKI), combined with bevacizumab (7.5 mg/kg every 3 weeks) in 78 patients with EGFR-mutant non-small cell lung cancer (NSCLC) and central nervous system (CNS) metastases. The cohort comprised 31 patients (39.7%) with brain metastases (BM) only, and 47 patients (60.3%) with concurrent brain and leptomeningeal metastases (LM). All had experienced disease progression after prior treatment with third-generation EGFR TKIs.<br /><br />Primary endpoints were intracranial progression-free survival (iPFS) and overall progression-free survival (PFS), with secondary endpoints including intracranial objective response rate (iORR), objective response rate (ORR), and safety. Results showed a median iPFS of 7.63 months and median PFS of 6.37 months for the overall cohort. The iORR was 29.5%, and ORR was 42.3%. Among patients with concurrent BM and LM, median iPFS and PFS were 7.63 and 5.80 months, with iORR and ORR of 31.9% and 53.2%, respectively. In those with BM only, median iPFS and PFS were 7.20 and 6.70 months, with both iORR and ORR at 25.8%. <br /><br />Multivariate analysis identified EGFR exon 19 deletion, uncommon EGFR mutations, and concurrent radiotherapy as independent predictors of prolonged iPFS. The treatment was well-tolerated; grade 3 treatment-related adverse events occurred in only 2.6% of patients (hypertension), with no treatment-related deaths.<br /><br />In conclusion, high-dose furmonertinib plus bevacizumab showed promising intracranial and systemic efficacy with a favorable safety profile in EGFR-mutant NSCLC patients with CNS metastases after resistance to prior third-generation EGFR-TKI therapy, suggesting it as a potential therapeutic option in this challenging clinical setting.

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li kun chen

Meta Tag

Speaker li kun chen

Topic Metastatic Non-small Cell Lung Cancer – Targeted Therapy

Keywords

high-dose furmonertinib

bevacizumab

EGFR-mutant NSCLC

central nervous system metastases

third-generation EGFR TKI resistance

intracranial progression-free survival

objective response rate

brain metastases

leptomeningeal metastases

treatment safety