Erlotinib in the Treatment of Lung Cancer With Leptomeningeal Metastases
Posted: Thursday, September 10, 2020
For patients with EGFR-mutated non–small cell lung cancer (NSCLC) who have leptomeningeal metastasis, treatment with the monoclonal antibody erlotinib may prove to be a useful treatment option, according to a phase II, multicenter, single-arm study (LOGIK1101) published in The Oncologist. This is reportedly the first prospective study to identify an active chemotherapeutic drug in this setting, according to Kenji Sugio, MD, PhD, FACS, of the National Kyushu Cancer Center, Japan, and colleagues.
“There was a good correlation between plasma and cerebrospinal fluid concentrations, although there was no clear correlation between pharmacokinetic parameters and clinical outcome,” explained the investigators.
From 2011 to 2015, a total of 21 patients who had NSCLC with leptomeningeal metastases were enrolled in the study. Diagnosis was confirmed utilizing cytology. All patients were women and nonsmokers. A total of 17 patients had EGFR mutations. All patients tested negative for the T790M mutation based on cerebrospinal fluid specimens.
The study findings revealed a clearance rate of 30% (confidence interval = 11.9%–54.3%) and a median overall survival of 3.4 months. In addition, the median time to leptomeningeal metastases was 2.2 months in this patient population. Patients with EGFR-mutant disease demonstrated longer time to leptomeningeal metastases and overall survival times as compared with patients without this mutation.
Moreover, there was a 3.3% mean cerebrospinal fluid penetration rate in patients with EGFR-mutated disease. This penetration rate was consistent with established data about leptomeningeal metastasis in the literature. Furthermore, assessment of the Eastern Cooperative Oncology Group performance status following treatment demonstrated improvement in 33.3% of patients.
Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.