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  • Leptomeningeal disease LMD is distinct from BM

    2019-09-02

    Leptomeningeal disease (LMD) is distinct from BM as its incidence is less frequent in ALK-positive NSCLC patients and is associated with poorer prognosis [1]. The efficacy of next-generation ALK inhibitors is less known as patients with LMD have often been excluded from trials. Some reported cases have been published on the efficacy of other ALK TKi, such as alectinib, on leptomeningeal carcinomatosis [7,8]. Yet, for brigatinib, they Dalbavancin remain few with a distance of 9 months for the best [9]. In addition with our latest case, emerging facts suggest brigatinib’s durable intra-cranial activity in BM as well as LM in ALK-positive NSCLC patients (Table 1).
    Conclusion To conclude, we reported the first case of successful prolonged intra-cranial response to brigatinib in a deciduous patient with ALK-positive advanced lung adenocarcinoma presenting with leptomeningeal disease, with initial poor prognosis. Our case provides additional data to support brigatinib intra-cranial efficiency over 1st and 2nd generation ALK-TKIs, including in LMD setting.
    Disclosures
    Acknowledgment