Abstract 64P
Background
This study aimed to assess the efficacy of furmonertinib in central nervous system(CNS) metastasis non-small cell lung cancer (NSCLC) patients with uncommon EGFR mutations, excluding exon 20 insertion mutations(Ex20ins).
Methods
This study conducted a retrospective analysis of data from 31 NSCLC patients with CNS metastases, all harboring uncommon EGFR mutations, treated at the Affiliated Brain Hospital of Nanjing Medical University between March 1, 2022, and August 31, 2024. Next-generation sequencing (NGS) was used to analyze circulating tumor DNA (ctDNA) from cerebrospinal fluid (CSF). All patients received treatment with furmonertinib, and patient data on clinical baseline information, treatment outcomes, survival, and safety were collected.
Results
The CNS objective response rate (ORR)was 38.7%, and the CNS disease control rate (DCR) was 64.5%, with a median intracranial progression-free survival (iPFS) of 6.97 months and median overall survival (OS) of NR. The CNS ORR for patients with solitary or compound uncommon EGFR mutations was 44.4% and 36.4%, respectively. The median iPFS for the solitary mutation group was 13.90 months and for the compound mutation group was 6.60 months, with OS were NR and 9.00 months, respectively. 21 leptomeningeal metastasis (LM) patients had baseline EGFR-mutant ctDNA detected in CSF, with ctDNA analysis indicating a positive treatment response with decreased or cleared ctDNA abundance. Additionally, we reported a case where ctDNA dynamic changes in CSF correlated well with the patient’s clinical assessment. The safety profile of furmonertinib was acceptable, with no grade 4 adverse events or treatment-related deaths.
Conclusions
Furmonertinib has shown promising clinical benefits and manageable toxicity in CNS metastatic NSCLC patients with uncommon EGFR mutations, supporting its use as a treatment option for this population.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.