Intrathecal pemetrexed chemotherapy combined with systemic therapy in patients with non-small cell lung cancer and leptomeningeal metastases: a retrospective study
BackgroundLeptomeningeal metastases (LM) in non-small cell lung cancer (NSCLC) present a challenging prognosis, with systemic therapies often limited by the blood-brain barrier. However, intrathecal pemetrexed injections can increase intracranial drug concentrations, aiding in disease control.Object...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1545174/full |
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| author | Wenjuan Zhong Wenjuan Zhong Longqiu Wu Longqiu Wu Zhengang Qiu Zhengang Qiu Wei Yu Linfang Liu Huaqiu Shi Huaqiu Shi Shugui Wu |
| author_facet | Wenjuan Zhong Wenjuan Zhong Longqiu Wu Longqiu Wu Zhengang Qiu Zhengang Qiu Wei Yu Linfang Liu Huaqiu Shi Huaqiu Shi Shugui Wu |
| author_sort | Wenjuan Zhong |
| collection | DOAJ |
| description | BackgroundLeptomeningeal metastases (LM) in non-small cell lung cancer (NSCLC) present a challenging prognosis, with systemic therapies often limited by the blood-brain barrier. However, intrathecal pemetrexed injections can increase intracranial drug concentrations, aiding in disease control.ObjectiveTo evaluate the efficacy and safety of combining intrathecal pemetrexed with systemic therapy in patients with NSCLC and LM.MethodsThirty-one patients with NSCLC and LM who received intrathecal pemetrexed chemotherapy between 2018 and 2022 at First Affiliated Hospital of Gannan Medical College were retrospectively reviewed.ResultsOf the 31 patients enrolled, six had LM at initial diagnosis. The median number of intrathecal pemetrexed injections was 4 (2-26), with an intracranial control rate of 87.1% (27/31). Median iPFS was 9 months (95% CI: 2.77-15.23), and median iOS was 12 months (95% CI: 5.94-18.06 months). Most adverse events (AEs) were grade 1-2, with four (12.9%) grade 3 AEs (including two cases of grade 3 leukopenia; one, grade 3 diarrhea; one, grade 3 interstitial pneumonitis). Univariate and multivariate analyses showed that the combination of bevacizumab (p<0.05) and an Eastern Cooperative Oncology Group(ECOG) score of ≤ 1 (p<0.05) were favorable prognostic factors for survival.ConclusionIntrathecal pemetrexed injections combined with systemic treatment demonstrated significant therapeutic efficacy and manageable safety in NSCLC patients with LM. |
| format | Article |
| id | doaj-art-afe3ca8aa5c34c2dab1a9cd2c4175a76 |
| institution | DOAJ |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-afe3ca8aa5c34c2dab1a9cd2c4175a762025-08-20T03:17:14ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-04-011510.3389/fonc.2025.15451741545174Intrathecal pemetrexed chemotherapy combined with systemic therapy in patients with non-small cell lung cancer and leptomeningeal metastases: a retrospective studyWenjuan Zhong0Wenjuan Zhong1Longqiu Wu2Longqiu Wu3Zhengang Qiu4Zhengang Qiu5Wei Yu6Linfang Liu7Huaqiu Shi8Huaqiu Shi9Shugui Wu10Department of Oncology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, ChinaJiangxi Clinical Medical Center for Cancer, Ganzhou, Jiangxi, ChinaDepartment of Oncology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, ChinaJiangxi Clinical Medical Center for Cancer, Ganzhou, Jiangxi, ChinaDepartment of Oncology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, ChinaJiangxi Clinical Medical Center for Cancer, Ganzhou, Jiangxi, ChinaThe First Clinical Medical College, Gannan Medical University, Ganzhou, Jiangxi, ChinaThe First Clinical Medical College, Gannan Medical University, Ganzhou, Jiangxi, ChinaDepartment of Oncology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, ChinaJiangxi Clinical Medical Center for Cancer, Ganzhou, Jiangxi, ChinaDepartment of Oncology, The Affiliated Ganzhou Hospital, Jiangxi Medical College, Nanchang University, Ganzhou, Jiangxi, ChinaBackgroundLeptomeningeal metastases (LM) in non-small cell lung cancer (NSCLC) present a challenging prognosis, with systemic therapies often limited by the blood-brain barrier. However, intrathecal pemetrexed injections can increase intracranial drug concentrations, aiding in disease control.ObjectiveTo evaluate the efficacy and safety of combining intrathecal pemetrexed with systemic therapy in patients with NSCLC and LM.MethodsThirty-one patients with NSCLC and LM who received intrathecal pemetrexed chemotherapy between 2018 and 2022 at First Affiliated Hospital of Gannan Medical College were retrospectively reviewed.ResultsOf the 31 patients enrolled, six had LM at initial diagnosis. The median number of intrathecal pemetrexed injections was 4 (2-26), with an intracranial control rate of 87.1% (27/31). Median iPFS was 9 months (95% CI: 2.77-15.23), and median iOS was 12 months (95% CI: 5.94-18.06 months). Most adverse events (AEs) were grade 1-2, with four (12.9%) grade 3 AEs (including two cases of grade 3 leukopenia; one, grade 3 diarrhea; one, grade 3 interstitial pneumonitis). Univariate and multivariate analyses showed that the combination of bevacizumab (p<0.05) and an Eastern Cooperative Oncology Group(ECOG) score of ≤ 1 (p<0.05) were favorable prognostic factors for survival.ConclusionIntrathecal pemetrexed injections combined with systemic treatment demonstrated significant therapeutic efficacy and manageable safety in NSCLC patients with LM.https://www.frontiersin.org/articles/10.3389/fonc.2025.1545174/fullnon-small cell lung cancerleptomeningeal metastasespemetrexedintrathecal chemotherapyEGFR |
| spellingShingle | Wenjuan Zhong Wenjuan Zhong Longqiu Wu Longqiu Wu Zhengang Qiu Zhengang Qiu Wei Yu Linfang Liu Huaqiu Shi Huaqiu Shi Shugui Wu Intrathecal pemetrexed chemotherapy combined with systemic therapy in patients with non-small cell lung cancer and leptomeningeal metastases: a retrospective study Frontiers in Oncology non-small cell lung cancer leptomeningeal metastases pemetrexed intrathecal chemotherapy EGFR |
| title | Intrathecal pemetrexed chemotherapy combined with systemic therapy in patients with non-small cell lung cancer and leptomeningeal metastases: a retrospective study |
| title_full | Intrathecal pemetrexed chemotherapy combined with systemic therapy in patients with non-small cell lung cancer and leptomeningeal metastases: a retrospective study |
| title_fullStr | Intrathecal pemetrexed chemotherapy combined with systemic therapy in patients with non-small cell lung cancer and leptomeningeal metastases: a retrospective study |
| title_full_unstemmed | Intrathecal pemetrexed chemotherapy combined with systemic therapy in patients with non-small cell lung cancer and leptomeningeal metastases: a retrospective study |
| title_short | Intrathecal pemetrexed chemotherapy combined with systemic therapy in patients with non-small cell lung cancer and leptomeningeal metastases: a retrospective study |
| title_sort | intrathecal pemetrexed chemotherapy combined with systemic therapy in patients with non small cell lung cancer and leptomeningeal metastases a retrospective study |
| topic | non-small cell lung cancer leptomeningeal metastases pemetrexed intrathecal chemotherapy EGFR |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1545174/full |
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