Impact of intrathecal pemetrexed on survival of patients with leptomeningeal metastasis from lung adenocarcinoma

A retrospective propensity score matched study at Fujian Medical University Cancer Hospital (Fuzhou, China) evaluated intrathecal pemetrexed (IP) among patients with leptomeningeal metastasis (LM) from lung adenocarcinoma. Median overall survival was 13.2 months in the IP group versus 10.1 months in the non-IP group (p=0.488). Multivariate competing-risks analysis showed that IP significantly reduced the risk of central nervous system-related death (HR 0.31; p=0.046). In analysis stratified by ECOG performance status, IP was associated with improved survival in patients with PS 2 (14.3 months versus 1.6 months; p=0.003). The authors conclude that IP did not improve survival among all patients, but was associated with reduced risk of CNS-related mortality and with improved survival of patients with poor ECOG PS.