Intracranial efficacy of alectinib in ALK-positive NSCLC patients with CNS metastases—a multicenter retrospective study

Central nervous system (CNS) metastases in patients with ALK-positive non-small cell lung cancer (NSCLC) are a cause of substantial morbidity and mortality. Although alectinib had demonstrated promising intracranial efficacy in several clinical trials, data were limited on its CNS activity in real-world settings. Our study substantiated the potent CNS activity of alectinib in real-world settings. Patients with symptomatic and asymptomatic BM could benefit from alectinib comparatively, which indicated that alectinib alone might defer the timing of local treatment. However, our results should be treated cautiously owing to limited sample size. READ ARTICLE

BMC Med DOI:10.1186/s12916-021-02207-x

Authors: Zou Z, Xing P, Hao X, Wang Y, Song X, Shan L, Zhang C, Liu Z, Ma K, Dong G, Li J.

Efficacy and Safety of Intrathecal Pemetrexed Combined With Dexamethasone for Treating Tyrosine Kinase Inhibitor-Failed Leptomeningeal Metastases From EGFR-Mutant NSCLC

We aimed to evaluate the efficacy and safety of intrathecal pemetrexed (IP) for treating EGFR-mutant leptomeningeal metastases (LMs) from EGFR-mutant NSCLC. The RD observed in the phase 1 study was 50 mg pemetrexed. A total of 30 cases of LM-NSCLC were enrolled in the phase 2 study, including 14 males and 16 females. Four patients did not survive for 4 weeks and could not be evaluated for efficacy. The clinical response rate was 84.6% (22 of 26). The median overall survival of all patients was 9.0 months (n = 30, 95% confidence interval: 6.6–11.4 mo). Most AEs were mild, and the most frequent AE of any grade was myelosuppression (n = 9, 30%), which returned to normal after symptomatic treatment. This study revealed that 50 mg pemetrexed is the RD which results in few AEs and a good response rate. IP is an effective treatment for patients with EGFR-mutant NSCLC-LM who had failed on tyrosine kinase inhibitor...... READ ARTICLE

Journal of Thoracic Oncology DOI:10.1016/J.JTHO.2021.04.018

Authors: Chengjuan Fan, Qiuyu Zhao, Li Li, Weixi Shen, Yang Du, Chong Teng, Feng Gao, Xiaowei Song, Qiuying Jiang, Dayong Huang, Yinghua Jin, Yanju Lv, Lingxiao Wei, Tengfei Shi, Xue Zhao, Naisheng Gao, Zhengjun Jiang, Tao Xin

Clinical Utility of Cerebrospinal Fluid Cell-Free DNA as Liquid Biopsy for Leptomeningeal Metastases in ALK-Rearranged NSCLC

Introduction: Leptomeningeal metastases (LMs) indicated a poor prognosis in NSCLC. LMs were more frequent in driver gene–mutated patients, and cerebrospinal fluid (CSF) cell-free DNA has shown unique genetic profiles of LM in EGFR-mutated LM. However, studies in patients with ALK receptor tyrosine kinase gene (ALK)-rearranged NSCLC with LMs are scarce. Conclusion: Liquid biopsy of CSF is more sensitive than liquid biopsy of plasma to detect targetable alterations, characterizing resistance mechanisms on progression and monitoring tumor response in patients with ALK-rearranged NSCLC with LM. Thus, CSF might be promising as a medium of liquid biopsy in LM. READ ARTICLE

Journal of Thoracic Oncology
DOI:10.1016/j.jtho.2019.01.007

Authors: Mei-Mei Zheng, Yang-Si Li, Ben-Yuan Jiang, Hai-Yan Tu, Wen-Fang Tang, Jin-Ji Yang, Xu-Chao Zhang, Jun-Yi Ye, Hong-Hong Yan, Jian Su, Qing Zhou, Wen-Zhao Zhong, Xue-Ning Yang, Wei-Bang Guo, Shannon Chuai, Zhou Zhang, Hua-Jun Chen, Zhen Wang, Chao Liu, Yi-Long Wu