Triple-Dose Furmonertinib for Leptomeningeal Metastases in Advanced EGFR L858R-Mutated Lung Adenocarcinoma: A Case Report
DOI:
https://doi.org/10.82582/thorac.69Keywords:
Adenocarcinoma of Lung/drug therapy, Adenocarcinoma of Lung/genetics, Carcinoma, Non-Small-Cell Lung/drug therapy, Carcinoma, Non-Small-Cell Lung/genetics, ErbB Receptors/ genetics, Furmonertinib, Meningeal Neoplasms/secondaryAbstract
Leptomeningeal metastases (LM) are a devastating complication of non-small cell lung cancer (NSCLC), particularly in patients with epidermal growth factor receptor (EGFR) mutations. Despite the success of EGFR tyrosine kinase inhibitors (TKIs), central nervous system (CNS) progression remains common and associated with poor outcomes due to limited drug penetration. We report a 73-year-old woman with EGFR L858R-mutated NSCLC who developed LM after multiple lines of therapy, including gefitinib, osimertinib, chemotherapy, anti-angiogenic therapy, and radiotherapy. Treatment with high-dose furmonertinib (240 mg daily) combined with bevacizumab resulted in symptom relief and additional survival. Remarkably, her overall survival exceeded six years from initial diagnosis. This case highlights the potential role of dose-escalated furmonertinib as salvage therapy in LM after osimertinib resistance and underscores the importance of sequential and multimodal management in advanced EGFR-mutant NSCLC.Downloads
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