Osimertinib in combination with bevacizumab in EGFR-Mutated NSCLC with leptomeningeal metastases
Tao Jiang, Xiaobo Xu, Xiaojuan Chen, Ning Ding, Qin Hu, Caicun Zhou, Jie Hu
Abstract
Leptomeningeal metastases (LM) occur in approximately 5-15% of non-small-cell lung cancer (NSCLC) patients with EGFR mutations together with very poor prognosis, and there is no broadly accepted standard treatment (1). Although new-generation EGFR-TKIs have significantly prolonged both progression-free survival (PFS) and overall survival (OS) in patients with EGFR-mutated NSCLC (2,3), little is known about the efficacy of novel EGFR-TKIs (e.g., osimertinib) for patients with LM. Recently, Lee et al. compared the clinical outcomes of patients with EGFR-mutated NSCLC and LM received osimertinib with those not receive osimertinib in the Journal of Thoracic Oncology (4). Their data showed that patients with LM received osimertinib had significantly longer OS than those not treated with osimertinib (17.0 vs. 5.5 months, P<0.001), which suggested that osimertinib would be a good therapeutic option for patients with EGFR-mutated NSCLC and LM. Moreover, two recent publications suggested that combining EGFR-TKIs and bevacizumab may be efficacious for brain metastases (BMs) and protective against central nervous system (CNS) progression Herein, we presented one case to further investigate the efficacy and tolerability of osimertinib plus bevacizumab for patient with EGFR-mutated NSCLC and cytologically proven LM.