Osimertinib quantitative and gene variation analyses in cerebrospinal fluid and plasma of non-small cell lung cancer patient with leptomeningeal metastases.
CONCLUSIONS: ctDNA from CSF might be a useful biomarker for monitoring the efficacy of treatment and an effective complement to nuclear magnetic resonance (MRI) for LM. PMID: 30332963 [PubMed - as supplied by publisher]
Conclusion: Pemetrexed was appropriate for intrathecal administration. IP at 10 mg dose in combination with vitamin supplementation on the schedule of 1-2 times per week showed controllable toxicity and good efficacy. This regimen paves the way for subsequent clinical trial.
Few previous studies of patients with non-small cell lung cancer (NSCLC) and leptomeningeal metastases have used liquid biopsy of cerebrospinal fluid (CSF) to identify epidermal growth factor receptor (EGFR) mutations and guide therapy. A 34-year-old male patient with NSCLC and leptomeningeal metastases was admitted to the Interventional Radiology Department, Tianjin Huanhu Hospital on 18th April 2018 after showing no response to chemoradiotherapy. On admission, the patient was in critical condition with an estimated survival
Patients with non-small cell lung cancer (NSCLC) experience leptomeningeal metastases (LM) in 3 –9% of cases. Because overall survival (OS) and performance status are very poor, they are mostly excluded from clinical trials. Here, we evaluated survival of patients with NSCLC having LM treated with immune checkpoint inhibitors (ICIs).
Leptomeningeal metastases (LM) are a severe complication of systemic cancer usually occurring in advanced stages which affect approximately 1 –10% of patients with solid tumors. [1–6] The incidence of LM (3–5%) in advanced NSCLC has increased over the last 10 years, especially in subgroups of patients with targetable mutations [6–8]. Although therapies such as molecular targeted treatments and immunotherapies have been described, standard treatment for LM is yet to be established [6,8–13].The median OS of lung cancer patients with LM is poor though with improvement from a historical 1–3 ...
In this study, we performed capture-based targeted sequencing using a panel consisting of 168 lung cancer-related genes on matched CSF and plasma samples from 72 advanced NSCLC patients with confirmed LM to interrogate the potential of CSF as a source of liquid biopsy. RESULTS: We revealed a rate of detection of 81.5% and 62.5% for CSF and plasma, respectively (p = 0.008). The maximum allelic fraction (MaxAF) was also significantly higher in CSF (43.6% vs. 4.6%) (p
Abstract Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are effective in the treatment of advanced non-small-cell lung cancer (NSCLC) with leptomeningeal metastases (LM); however, a proportion of the patients with resistant tumors do not benefit from EGFR-TKI treatment. In the present study the case of a female patient with advanced lung adenocarcinoma harboring the EGFR L858R mutation (encoded in exon 21) who developed intracranial metastases following treatment with erlotinib after gefitinib failure is reported. The patient achieved a partial response (PR) after four cycles of chemothera...
We present the case of a 52-year-old female non-smoker with advanced lung adenocarcinoma and initially positive EGFR-mutation, who failed to the treatment of standard first-line chemotherapy (pemetrexed plus cisplatin) and bevacizumab (BEV), and maintenance therapy with pemetrexed plus BEV. Under the progression-free survival of 6 months, suffered from LMs, then erlotinib combined with BEV were delivered, and symptoms were significantly alleviated, remained stable and even relieved slightly for at least 18 months. The combination of bevacizumab and erlotinib could be an optional effective management strategy for ...
ConclusionsIn this non-selected population, osimertinib had remarkable efficacy in NSCLC patients with LM irrespective of the presence of theEGFR-T790M –resistance mutation. Osimertinib efficacy was rapid in several patients, even some with poor performance status.