ArticleThoracic cancer2020
Impact of clinicopathologic features on leptomeningeal metastasis from lung adenocarcinoma and treatment efficacy with epidermal growth factor receptor tyrosine kinase inhibitor.
Article in Thoracic cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- A comparative study of Ommaya reservoir versus lumbar puncture for intrathecal chemotherapy in patients with leptomeningeal metastasis: a systematic review and meta-analysis.Journal of neuro-oncology · 2026Pooled it
- Osimertinib combined with bevacizumab for leptomeningeal metastasis from EGFR-mutation non-small cell lung cancer: A phase II single-arm prospective clinical trial.Thoracic cancer · 2021Trial
- A nomogram prediction model for brain metastases in patients with lung adenocarcinoma.Oncology letters · 2026Article
- Advances in the research of leptomeningeal metastases in non-small cell lung cancer: a narrative review.Translational lung cancer research · 2025Review
- Leptomeningeal metastases at recurrence in IDH-wildtype glioblastomas: incidence, risk factors, and prognosis based on postcontrast FLAIR imaging.European radiology · 2025Article
- A review on intrathecal administration of medications for leptomeningeal metastases in solid tumors.Frontiers in pharmacology · 2025Review
- Effects of intrathecal pemetrexed on the survival of patients with leptomeningeal metastasis from lung adenocarcinoma: a propensity score matching analysis.Journal of neuro-oncology · 2023Article
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- First-line osimertinib for leptomeningeal metastasis from lung adenocarcinoma withInternational cancer conference journal · 2021Article
- Whole brain radiotherapy (WBRT) for leptomeningeal metastasis from NSCLC in the era of targeted therapy: a retrospective study.Radiation oncology (London, England) · 2020Article
- Treatment decision-making for leptomeningeal metastasis after TKI resistance in EGFR-mutant lung cancer: a comprehensive review on staging, resistance patterns, and multimodal interventions.Frontiers in neurologyReview
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundWe investigated the risk factors for leptomeningeal carcinomatosis (LMC) and compared clinical efficacies of various treatment modalities including intrathecal (IT) chemotherapy in patients with lung adenocarcinoma harboring epidermal growth factor receptor (EGFR) mutations.
methodsUsing clinical research data from the Asan Medical Center, we retrospectively analyzed data of patients diagnosed with LMC, confirmed via cerebrospinal fluid (CSF) analysis from January 2008 to December 2017.
resultsWe identified 1189 patients with lung adenocarcinoma harboring EGFR mutations. Among these, 9.8% had a median duration of 13.5 (interquartile range [IQR] 6.8-23.6) months from the initial lung cancer diagnosis to LMC occurrence. Younger age (hazard ratio [HR] 1.043, P < 0.001), initial metastatic disease (HR 3.768, P < 0.001), and metastasis to the brain (HR 8.682, P < 0.001) or lung (HR 2.317, P = 0.004) were risk factors associated with LMC. Median survival duration from LMC diagnosis was 3.8 (IQR 1.5-8.6) months. Eastern Cooperative Oncology Group performance status score ≤ 2 (HR 0.505, P = 0.007) and insertion of Ommaya reservoir (HR 0.445, P = 0.005) were associated with longer survival. EGFR-tyrosine kinase inhibitor (TKI) conferred survival benefits compared to cytotoxic chemotherapy or best supportive care (HR 2.222, P = 0.018; HR 5.638, P < 0.001, respectively). Although IT chemotherapy showed no survival benefit, it was associated with improved neurologic symptoms and signs and CSF negative conversion.
conclusionsYounger age, initial diagnosis of metastatic disease, and metastasis to the brain or different lobes were associated with LMC in patients with EGFR-mutant lung adenocarcinoma. Therapeutic interventions including EGFR-TKIs, cytotoxic chemotherapy, or Ommaya reservoir, and good performance status were related to favorable survival outcomes. KEY POINTS: Age and disease status were associated with LMC in patients with EGFR-mutant adenocarcinoma, and EGFR-TKI, Ommaya reservoir, and good performance status were related to survival benefit.
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