Retrospective cohort study of overall survival in patients with non-small cell lung cancer and leptomeningeal metastases

A retrospective cohort study of all patients with NSCLC and baseling leptomeningeal metastases (LM) registered in the Netherlands Cancer Registry between 2017 and 2023 (n=259) investigated disease characteristics, treatment patterns, and survival outcomes. At diagnosis, 44.8% of patients had a WHO performance status of 0-1, 47.1% were male, and 55.2% were aged over 65 years. Allmost all patients (91.5%) had non-squamous histology. Among 259 patients, 51.4% received best supportive care (BSC), 10.4% received chemotherapy-only, 22.8% received immune checkpoint inhibitors (ICIs) with or without chemotherapy, and 15.4% received targeted therapy. Median overall survival was 1.3 months (95% CI 1.0-1.5) with BSC, 8.0 months (4.8-11.3) with chemotherapy-only, 8.3 months (4.8-11.3) with (chemo-) ICI, and 20.5 months (16.7-24.3) with targeted therapy. The authors conclude that LM at NSCLC diagnosis should not be considered an automatic exclusion criterion for active treatment.