Evidence map›Paper›PMID 41125209›Full record

ArticleAnnals of oncology : official journal of the European Society for Medical Oncology2026

The evolving landscape of leptomeningeal metastases from NSCLC: an international, contemporary, multicenter cohort study.

M M Zheng, Y Xia, K Pan, F Sun, A C Tan, X R Dong, H Y Tu, L B Tang, Y S Li, K Yin and 26 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of oncology : official journal of the European Society for Medical Oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Article
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  4. Targeting ClassicalCancers · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

36 authors.

M M ZhengGuangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, P. R. China.
Y XiaDepartment of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China.
K PanDepartment of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, USA.
F SunDivision of Oncology, Department of Medicine, Stanford University, Stanford, USA.
A C TanDivision of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
X R DongCancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
H Y TuGuangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, P. R. China.
L B TangGuangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, P. R. China.
Y S LiGuangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, P. R. China.
K YinGuangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, P. R. China.
M BorgeaudDepartment of Oncology, University Hospital Geneva, Geneva, Switzerland.
S SinghalDivision of Hematology/Oncology, UC Davis Comprehensive Cancer Center, Sacramento, USA.
E ZhuDepartment of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA.
J ZhangDepartment of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA.
M NilssonDepartment of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA.
J WuDepartment of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, USA.
D L GibbonsDepartment of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA.
H WakeleeDivision of Oncology, Department of Medicine, Stanford University, Stanford, USA.
J W NealDivision of Oncology, Department of Medicine, Stanford University, Stanford, USA.
J LeeDepartment of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, USA.
A A VaporciyanThoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, USA.
W RingsurongkawongDepartment of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA.
H T TranDepartment of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA.
R Z ZhangDepartment of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, P. R. China.
T ZhangDepartment of Radiation Oncology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China.
Q ZhouGuangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, P. R. China; Guangdong Provincial Key Laboratory of Translation Medicine in Lung Cancer, Guangzhou, P. R. China.
W Z ZhongGuangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, P. R. China; Guangdong Provincial Key Laboratory of Translation Medicine in Lung Cancer, Guangzhou, P. R. China.
W LiDepartment of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China.
Y C ZhangDepartment of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, P. R. China.
J W RiessDivision of Hematology/Oncology, UC Davis Comprehensive Cancer Center, Sacramento, USA.
A AddeoDepartment of Oncology, University Hospital Geneva, Geneva, Switzerland.
J V HeymachDepartment of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA.
N MyallDivision of Oncology, Department of Medicine, Stanford University, Stanford, USA.
D TanDivision of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
Y L WuGuangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, P. R. China; Guangdong Provincial Key Laboratory of Translation Medicine in Lung Cancer, Guangzhou, P. R. China. Electronic address: syylwu@live.cn.
X LeDepartment of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: xle1@mdanderson.org.

Funding

UC Davis Paul Calabresi K12 Clinical Oncology Research Career Development ProgramK12CA138464 · NCI · UNIVERSITY OF CALIFORNIA AT DAVIS · PI BIRKELAND, ANDREW CHARLES, LARA, PRIMO N. · 2011 to 2025
$11.4M
NCI NIH HHS K12 CA138464
6 · The paper itself

Abstract

backgroundLeptomeningeal metastatic disease (LMD) represents a devastating complication of non-small-cell lung cancer (NSCLC) with a poor prognosis. Our understanding of LMD is limited in the era of molecular testing and emerging therapeutic options for lung cancer. PATIENTS AND

methodsWe conducted an international, multicenter, retrospective study involving eight institutions across Asia, United States, and Europe. Patients diagnosed with LMD from advanced NSCLC were identified (2007-2024). Clinicopathological characteristics, treatment patterns, and outcomes were analyzed. The primary endpoint was overall survival from the LMD diagnosis (LMOS).

resultsA total of 2052 patients with NSCLC and LMD were included and analyzed by molecular subtypes: epidermal growth factor receptor (EGFR) (n = 1610), ALK (n = 141), other actionable genomic alterations (other AGA; n = 137), and non-AGA (n = 164). The cumulative prevalence of LMD by molecular subgroups was EGFR, 11.1%; ALK, 11.2%; ROS1, 16%; ERBB2, 12.3%, non-AGA, 3.6%. A higher proportion of LMD was diagnosed >3 years after initial metastatic diagnosis. By the European Association of Neuro-Oncology (EANO)-European Society for Medical Oncology (ESMO) diagnostic criteria, type I (cerebrospinal fluid cytology positive) had significantly shorter LMOS than type II (magnetic resonance imaging and/or symptom positive). Median LMOS was 10.9 months [95% confidence interval (CI) 10.0-11.8 months] in all patients. Compared with historical cohorts, patients demonstrated improved LMOS in contemporary cohorts (7.3 versus 11.5 months, P < 0.0001), across all molecular subtypes. In AGA NSCLC, tyrosine kinase inhibitors (TKIs) were associated with improved LMOS [hazard ratio (HR) 0.39, 95% CI 0.31-0.48, P < 0.0001]. Immune checkpoint inhibitors (ICIs) conferred survival benefit in non-AGA patients (HR 0.45, 95% CI 0.25-0.84, P = 0.012). For the EGFR-mutated cohort, central nervous system (CNS)-penetrant TKI usage delayed LMD onset (P < 0.0001). Continued CNS-penetrant TKIs after LMD diagnosis were associated with longer LMOS (12.4 versus 6.0 months, P < 0.0001).

conclusionsThe prevalence of LMD is rising, largely due to prolonged survival in advanced NSCLC. Contemporary systemic treatments, including TKIs and ICIs, were the main contributors to delayed LMD onset and improved LMD survival.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsMeningeal CarcinomatosisMeningeal NeoplasmsAdultAgedAged, 80 and overAnaplastic Lymphoma KinaseErbB ReceptorsEuropeFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesAnaplastic Lymphoma KinaseEGFR protein, humanErbB Receptorscontemporaryleptomeningeal metastatic diseasenon-small-cell lung cancer

Identifiers

PMID41125209
PMCPMC12981536

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