Case report: A case report and literature review on the efficacy of high-dose aumolertinib combined intrathecal pemetrexed by Ommaya reservoir for EGFR-mutated NSCLC with leptomeningeal metastasis as the initial symptoms
Leptomeningeal metastasis (LM) is a significant complication of advanced non-small cell lung cancer (NSCLC), occurring in only 3-5% of patients and exceedingly rare in newly diagnosed NSCLC patients. This also indicates that the tumor is highly malignant and aggressive, which brings great challenges...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1502934/full |
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| author | Maoxi Zhong Maoxi Zhong Maoxi Zhong Li Zhou Li Zhou Li Zhou Jing Guo Jing Guo Jing Guo Chuan Chen Chuan Chen Chuan Chen Wei Wang Wei Wang Wei Wang Xiaoping Huang Xiaoping Huang Xiaoping Huang Yi Liu Yi Liu Yi Liu |
| author_facet | Maoxi Zhong Maoxi Zhong Maoxi Zhong Li Zhou Li Zhou Li Zhou Jing Guo Jing Guo Jing Guo Chuan Chen Chuan Chen Chuan Chen Wei Wang Wei Wang Wei Wang Xiaoping Huang Xiaoping Huang Xiaoping Huang Yi Liu Yi Liu Yi Liu |
| author_sort | Maoxi Zhong |
| collection | DOAJ |
| description | Leptomeningeal metastasis (LM) is a significant complication of advanced non-small cell lung cancer (NSCLC), occurring in only 3-5% of patients and exceedingly rare in newly diagnosed NSCLC patients. This also indicates that the tumor is highly malignant and aggressive, which brings great challenges to treatment. Here we present a case report of an EGFR-mutated NSCLC patient who presented with LM as the primary clinical manifestation, and review the latest advances in existing studies on LM-related treatment. The patient underwent multiple cycles of high-dose aumolertinib in combination with intrathecal pemetrexed administered via Ommaya reservoir. As of the submission date, the patient achieved significant remission and a LM Progression-Free Survival (PFS) exceeding 20 months. This case highlights the positive impact of high-dose aumolertinib combined with intrathecal pemetrexed on NSCLC patients presenting with severe meningeal symptoms as the initial manifestation, offering a viable therapeutic approach for managing severe meningeal symptoms associated with LM, such as headache, nausea, neck stiffness, and vomiting. |
| format | Article |
| id | doaj-art-7bfbefcbe8a64750bc28ecfbb6ada545 |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-7bfbefcbe8a64750bc28ecfbb6ada5452025-01-30T05:10:09ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-01-011510.3389/fonc.2025.15029341502934Case report: A case report and literature review on the efficacy of high-dose aumolertinib combined intrathecal pemetrexed by Ommaya reservoir for EGFR-mutated NSCLC with leptomeningeal metastasis as the initial symptomsMaoxi Zhong0Maoxi Zhong1Maoxi Zhong2Li Zhou3Li Zhou4Li Zhou5Jing Guo6Jing Guo7Jing Guo8Chuan Chen9Chuan Chen10Chuan Chen11Wei Wang12Wei Wang13Wei Wang14Xiaoping Huang15Xiaoping Huang16Xiaoping Huang17Yi Liu18Yi Liu19Yi Liu20Department of Cancer Center, Chongqing University Three Gorges Hospital, Chongqing, ChinaSchool of Medicine, Chongqing University, Chongqing, ChinaChongqing Municipality Clinical Research Center for Geriatric Diseases, Chongqing, ChinaDepartment of Cancer Center, Chongqing University Three Gorges Hospital, Chongqing, ChinaSchool of Medicine, Chongqing University, Chongqing, ChinaChongqing Municipality Clinical Research Center for Geriatric Diseases, Chongqing, ChinaDepartment of Cancer Center, Chongqing University Three Gorges Hospital, Chongqing, ChinaSchool of Medicine, Chongqing University, Chongqing, ChinaChongqing Municipality Clinical Research Center for Geriatric Diseases, Chongqing, ChinaDepartment of Cancer Center, Chongqing University Three Gorges Hospital, Chongqing, ChinaSchool of Medicine, Chongqing University, Chongqing, ChinaChongqing Municipality Clinical Research Center for Geriatric Diseases, Chongqing, ChinaDepartment of Cancer Center, Chongqing University Three Gorges Hospital, Chongqing, ChinaSchool of Medicine, Chongqing University, Chongqing, ChinaChongqing Municipality Clinical Research Center for Geriatric Diseases, Chongqing, ChinaDepartment of Cancer Center, Chongqing University Three Gorges Hospital, Chongqing, ChinaSchool of Medicine, Chongqing University, Chongqing, ChinaChongqing Municipality Clinical Research Center for Geriatric Diseases, Chongqing, ChinaSchool of Medicine, Chongqing University, Chongqing, ChinaChongqing Municipality Clinical Research Center for Geriatric Diseases, Chongqing, ChinaDepartment of Thoracic Surgery, Chongqing University Three Gorges Hospital, Chongqing, ChinaLeptomeningeal metastasis (LM) is a significant complication of advanced non-small cell lung cancer (NSCLC), occurring in only 3-5% of patients and exceedingly rare in newly diagnosed NSCLC patients. This also indicates that the tumor is highly malignant and aggressive, which brings great challenges to treatment. Here we present a case report of an EGFR-mutated NSCLC patient who presented with LM as the primary clinical manifestation, and review the latest advances in existing studies on LM-related treatment. The patient underwent multiple cycles of high-dose aumolertinib in combination with intrathecal pemetrexed administered via Ommaya reservoir. As of the submission date, the patient achieved significant remission and a LM Progression-Free Survival (PFS) exceeding 20 months. This case highlights the positive impact of high-dose aumolertinib combined with intrathecal pemetrexed on NSCLC patients presenting with severe meningeal symptoms as the initial manifestation, offering a viable therapeutic approach for managing severe meningeal symptoms associated with LM, such as headache, nausea, neck stiffness, and vomiting.https://www.frontiersin.org/articles/10.3389/fonc.2025.1502934/fullhigh-dose aumolertinibintrathecal chemotherapyleptomeningeal metastasisNSCLCcase report |
| spellingShingle | Maoxi Zhong Maoxi Zhong Maoxi Zhong Li Zhou Li Zhou Li Zhou Jing Guo Jing Guo Jing Guo Chuan Chen Chuan Chen Chuan Chen Wei Wang Wei Wang Wei Wang Xiaoping Huang Xiaoping Huang Xiaoping Huang Yi Liu Yi Liu Yi Liu Case report: A case report and literature review on the efficacy of high-dose aumolertinib combined intrathecal pemetrexed by Ommaya reservoir for EGFR-mutated NSCLC with leptomeningeal metastasis as the initial symptoms Frontiers in Oncology high-dose aumolertinib intrathecal chemotherapy leptomeningeal metastasis NSCLC case report |
| title | Case report: A case report and literature review on the efficacy of high-dose aumolertinib combined intrathecal pemetrexed by Ommaya reservoir for EGFR-mutated NSCLC with leptomeningeal metastasis as the initial symptoms |
| title_full | Case report: A case report and literature review on the efficacy of high-dose aumolertinib combined intrathecal pemetrexed by Ommaya reservoir for EGFR-mutated NSCLC with leptomeningeal metastasis as the initial symptoms |
| title_fullStr | Case report: A case report and literature review on the efficacy of high-dose aumolertinib combined intrathecal pemetrexed by Ommaya reservoir for EGFR-mutated NSCLC with leptomeningeal metastasis as the initial symptoms |
| title_full_unstemmed | Case report: A case report and literature review on the efficacy of high-dose aumolertinib combined intrathecal pemetrexed by Ommaya reservoir for EGFR-mutated NSCLC with leptomeningeal metastasis as the initial symptoms |
| title_short | Case report: A case report and literature review on the efficacy of high-dose aumolertinib combined intrathecal pemetrexed by Ommaya reservoir for EGFR-mutated NSCLC with leptomeningeal metastasis as the initial symptoms |
| title_sort | case report a case report and literature review on the efficacy of high dose aumolertinib combined intrathecal pemetrexed by ommaya reservoir for egfr mutated nsclc with leptomeningeal metastasis as the initial symptoms |
| topic | high-dose aumolertinib intrathecal chemotherapy leptomeningeal metastasis NSCLC case report |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1502934/full |
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