Intrathecal combined therapy for leptomeningeal metastasis from lung adenocarcinoma: Treatment outcomes, response and prognostic analysis

Abstract Purpose: Leptomeningeal metastasis (LM) is a seriously fatal complication of patients with lung adenocarcinoma. Intrathecal therapy (IT) combined with systemic therapy is one of the therapeutic approaches for LM. The purpose of this study is to assess the characteristics, response to IT combined therapy and determinants of patients with leptomeningeal metastasis from lung adenocarcinoma (LM-LA). Methods: We retrospectively analyzed the medical records of 37 patients with LM-LA who were treated by IT combined therapy between April 2018 and August 2022 from the database of Beijing Tiantan Hospital. Results: The median overall survival (mOS) of the 37 patients was 16.0 months. 21 patients who received IT combined TKIs, the mOS was 17.0 months which was longer than patients treated with IT combined chemotherapy (7.0 months), PD-1(6.0 months) and best support care (5.0 months). Combination of TKIs was independent favorable prognostic factors for patients with LM-LA. Conclusion: Combination therapy is considered to be another choice for patients of LM-LA. Compared with other combination therapy in our study，IT combined TKIs therapy provided a better survival outcome for patients with LM-LA.