*May 2025*
Background: Leptomeningeal metastasis (LM) is an infrequent and challenging site of metastasis in patients with non-small cell lung cancer (NSCLC). Currently, there is no standardized treatment protocol or consensus for managing NSCLC patients with LM. This study aims to comprehensively evaluate the efficacy and safety of targeted therapy in NSCLC patients with LM, with the goal of providing valuable data to inform treatment strategies for this challenging patient population.
Methods: All patients were diagnosed with LM by cerebrospinal fluid cytology and magnetic resonance imaging combined with typical clinical symptoms.
Results: We included 193 NSCLC patients with LM who received targeted therapy. Of these, 60 patients also received concurrent leptomeningeal local therapy, including chemotherapy or radiotherapy, while 133 patients did not receive synchronous therapy. In the entire cohort, the median progression-free survival (mPFS) for patients receiving targeted therapy was 6.9 months, and the median overall survival (mOS) was 15.0 months. Significant differences in mPFS and mOS were observed between the synchronous and non-synchronous therapy groups (PFS: 11.4 vs. 6.5 months, P=0.02; mOS: 18.1 vs. 13.6 months, P=0.04). Multivariate analysis identified performance status (PS) score (P=0.01), number of treatment lines (P=0.003), combination with angiogenesis inhibitors (P=0.001), and receipt of local leptomeningeal therapy (P=0.006) as independent factors influencing PFS.
Conclusions: Targeted therapies have demonstrated promising results in LM patients from advanced NSCLC, particularly in those receiving concurrent local leptomeningeal therapy. Read more.
