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Treatment response to intrathecal chemotherapy with pemetrexed via an Ommaya reservoir in EGFR-mutated leptomeningeal metastases from non-small cell lung cancer: a case report.
Ann Palliat Med. 2020 Jul; 9(4):2341-2346.AP

Abstract

Leptomeningeal metastasis (LM) is one of the most severe complications of non-small cell lung cancer (NSCLC), and it lacks standard treatment guidelines and is always accompanied by poor prognosis. We report a patient who was definitively diagnosed as LM from NSCLC with a targeted mutation of epidermal growth factor receptor (EGFR) via magnetic resonance imaging (MRI) and positive cerebrospinal fluid (CSF) cytology. Tyrosine kinase inhibitors (TKIs) were implemented but ineffective. Then the patient received the installation of an intraventricular Ommaya reservoir. Thirty mg of pemetrexed and other adjuvant treatments were implemented on days 1 and 8 every 3 weeks via the Ommaya reservoir. This treatment regimen resulted in the alleviation of the neurological symptoms, the clearing of CSF cytology and a reduced lesion of LM without notable side effects. At recent follow-ups, MRI examinations revealed the sustained stable LM lesion. We report the first successful example of administering intrathecal chemotherapy with pemetrexed via an Ommaya reservoir, providing a new therapeutic approach against LM from NSCLC.

Authors+Show Affiliations

Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.Department of Neurosurgery, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China. liuxiangyumail@163.com.Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China. zhenyuyin68@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32648459

Citation

Li, Huiying, et al. "Treatment Response to Intrathecal Chemotherapy With Pemetrexed Via an Ommaya Reservoir in EGFR-mutated Leptomeningeal Metastases From Non-small Cell Lung Cancer: a Case Report." Annals of Palliative Medicine, vol. 9, no. 4, 2020, pp. 2341-2346.
Li H, Lin Y, Yu T, et al. Treatment response to intrathecal chemotherapy with pemetrexed via an Ommaya reservoir in EGFR-mutated leptomeningeal metastases from non-small cell lung cancer: a case report. Ann Palliat Med. 2020;9(4):2341-2346.
Li, H., Lin, Y., Yu, T., Xie, Y., Feng, J., Huang, M., Guo, A., Liu, X., & Yin, Z. (2020). Treatment response to intrathecal chemotherapy with pemetrexed via an Ommaya reservoir in EGFR-mutated leptomeningeal metastases from non-small cell lung cancer: a case report. Annals of Palliative Medicine, 9(4), 2341-2346. https://doi.org/10.21037/apm-19-521
Li H, et al. Treatment Response to Intrathecal Chemotherapy With Pemetrexed Via an Ommaya Reservoir in EGFR-mutated Leptomeningeal Metastases From Non-small Cell Lung Cancer: a Case Report. Ann Palliat Med. 2020;9(4):2341-2346. PubMed PMID: 32648459.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment response to intrathecal chemotherapy with pemetrexed via an Ommaya reservoir in EGFR-mutated leptomeningeal metastases from non-small cell lung cancer: a case report. AU - Li,Huiying, AU - Lin,Yongjuan, AU - Yu,Tingting, AU - Xie,Yu, AU - Feng,Jie, AU - Huang,Mingmin, AU - Guo,Aibin, AU - Liu,Xiangyu, AU - Yin,Zhenyu, Y1 - 2020/06/30/ PY - 2019/11/20/received PY - 2020/04/10/accepted PY - 2020/7/11/pubmed PY - 2020/7/11/medline PY - 2020/7/11/entrez KW - Non-small cell lung cancer (NSCLC) KW - Ommaya reservoirs KW - case report KW - leptomeningeal metastases (LM) KW - pemetrexed SP - 2341 EP - 2346 JF - Annals of palliative medicine JO - Ann Palliat Med VL - 9 IS - 4 N2 - Leptomeningeal metastasis (LM) is one of the most severe complications of non-small cell lung cancer (NSCLC), and it lacks standard treatment guidelines and is always accompanied by poor prognosis. We report a patient who was definitively diagnosed as LM from NSCLC with a targeted mutation of epidermal growth factor receptor (EGFR) via magnetic resonance imaging (MRI) and positive cerebrospinal fluid (CSF) cytology. Tyrosine kinase inhibitors (TKIs) were implemented but ineffective. Then the patient received the installation of an intraventricular Ommaya reservoir. Thirty mg of pemetrexed and other adjuvant treatments were implemented on days 1 and 8 every 3 weeks via the Ommaya reservoir. This treatment regimen resulted in the alleviation of the neurological symptoms, the clearing of CSF cytology and a reduced lesion of LM without notable side effects. At recent follow-ups, MRI examinations revealed the sustained stable LM lesion. We report the first successful example of administering intrathecal chemotherapy with pemetrexed via an Ommaya reservoir, providing a new therapeutic approach against LM from NSCLC. SN - 2224-5839 UR - https://www.unboundmedicine.com/medline/citation/32648459/Treatment_response_to_intrathecal_chemotherapy_with_pemetrexed_via_an_Ommaya_reservoir_in_EGFR-mutated_leptomeningeal_metastases_from_non-small_cell_lung_cancer:_a_case_report L2 - https://doi.org/10.21037/apm-19-521 DB - PRIME DP - Unbound Medicine ER -
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