ArticleJournal of thoracic disease2025
Intrathecal pemetrexed in patients with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) resistant refractory leptomeningeal metastasis lung adenocarcinoma: a retrospective study.
Article in Journal of thoracic disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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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.
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Who cites it
1 citing paper in PubMed.
- Leptomeningeal metastasis from large-cell neuroendocrine carcinoma of the cervix: a case report and literature review.Frontiers in oncology · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The incidence of meningeal metastasis in lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutations is rising annually. Refractory meningeal metastasis following EGFR-tyrosine kinase inhibitor (EGFR-TKI) resistance presents a significant clinical challenge, lacking effective treatments and often leading to fatal outcomes. This study aims to evaluate the antitumor efficacy and safety of intrathecal pemetrexed in patients with EGFR-TKI-resistant meningeal metastasis. Methods: From November 1, 2020 to November 1, 2022, a total of 10 patients were enrolled. All underwent next-generation sequencing (NGS) and carcino-embryonic antigen (CEA) testing of cerebrospinal fluid (CSF). These patients had previously experienced symptomatic and supportive treatment, EGFR-TKI resistance, systemic intravenous chemotherapy, and bevacizumab therapy. Intrathecal pemetrexed was administered at doses of 20 or 40 mg once weekly and was well-tolerated. Results: The disease control rate (DCR) was 88.8% (8/9), with 10% (1/10) showing negative CSF cytology. Quality of life (QoL) scores improved, and CSF CEA levels decreased. The median progression-free survival (PFS) was 5 months, and the median overall survival (OS) was 8.15 months. Adverse events occurred in 90% of patients, with nausea, vomiting, and myelosuppression being the most common. Grade 3 or higher adverse events were observed in 40% (4/10) of patients, primarily myelosuppression, which improved with systemic treatment. No treatment-related deaths occurred. Conclusions: This study suggests that intrathecal pemetrexed can be a viable salvage treatment for refractory meningeal metastasis in EGFR-TKI-resistant lung adenocarcinoma.
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