Comparing intra-pemetrexed with osimertinib for treating leptomeningeal metastasis in lung cancer
Official title: A Clinical Trial of Intra-pemetrexed Plus Third-generation Small Molecule TKI Drugs (e.g. 'Osimertinib') Versus Third-generation Small Molecule TKI Drugs Alone for Leptomeningeal Metastasis From Epidermal Growth Factor Receptor Mutation-Positive Non-Small-cell Lung Cancer
Run by Guangzhou Medical University · NCT06304441 · Data updated 2026-11-12
This study is testing whether combining a specific type of chemotherapy with a targeted lung cancer drug can help people with leptomeningeal metastasis from lung cancer feel better compared to using the targeted drug alone.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years to 75 Years |
| Sex | All |
| Enrollment | 100 (estimated) |
| Sponsor | Guangzhou Medical University Academic / other |
| Drugs / interventions | osimertinib, chemotherapy |
| Locations | 1 site (Huizhou, Guangdong) |
| Status | Recruiting |
| Started | April 18, 2024 |
| Main results expected | June 20, 2026 |
| Study ends | September 2026 |
| Registry record updated | September 29, 2025 |
| Trial ID | NCT06304441 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Ideal candidates are adults aged 18 to 75 with confirmed EGFR mutation-positive NSCLC and leptomeningeal metastasis.
✕Probably not a fit
Patients with severe nervous system diseases or extensive systemic diseases without effective treatment may not benefit from this study.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This study aims to evaluate the effectiveness of combining intrathecal pemetrexed with third-generation small molecule tyrosine kinase inhibitors (TKIs), such as osimertinib, against using TKIs alone in patients with leptomeningeal metastasis from epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC). The research will involve patients aged 18 to 75 who have confirmed diagnoses of NSCLC with specific EGFR mutations and leptomeningeal metastasis. The study will assess treatment outcomes based on established clinical guidelines and previous research indicating the efficacy of these treatments. By comparing these two approaches, the study seeks to determine if the combination therapy offers superior benefits for patients.
Why it matters
Potential benefit: If successful, this treatment approach could significantly improve outcomes for patients with leptomeningeal metastasis from EGFR mutation-positive NSCLC.
How similar studies have gone: Previous studies have shown promising results with similar treatment approaches, particularly with the use of osimertinib in this patient population.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: 1. Male or female aged between 18 and 75 years. 2. Histologically or cytologically confirmed diagnosis of NSCLC with single activating EGFR mutations (L858R or Exon19Del). 3. Confirmed diagnosis of leptomeningeal metastasis according to ESMO/EANO guidelines. 4. Normal liver and kidney function; WBC≥4000/mm3, Plt≥100000/mm3. 5. No history of severe nervous system disease. 6. No severe dyscrasia. Exclusion Criteria: 1. Any evidence of nervous system failure, including severe encephalopathy, grade 3 or 4 leukoencephalopathy on imaging, and Glasgow Coma Score less than 11. 2. Any evidence of extensive and lethal progressive systemic diseases without effective treatment. 3. Patients with poor compliance or other reasons that were unsuitable for this study.
Where it's running
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The Third People's Hospital of Huizhou (Huizhou Hospital of Guangzhou Medical University)
Huizhou, Guangdong, China Recruiting
Study contacts
- Study coordinator: Zhenyu Pan
- Email: dr-zypan@163.com
- Phone: +8615804302753
Similar studies
Other studies for the same condition or treatment. Recruiting studies are listed first.
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Intrathecal pemetrexed for leptomeningeal metastases after osimertinib in lung adenocarcinoma
This trial will try giving pemetrexed directly into the spinal fluid to treat leptomeningeal metastases in people with EGFR‑mutant lung adenocarcinoma whose cancer progressed after double‑dose osimertinib.
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Pemetrexed injected into the spinal fluid for EGFR‑mutant lung cancer that has spread to the leptomeninges.
This tests whether giving pemetrexed directly into the spinal fluid helps people with EGFR‑mutant non‑small cell lung cancer whose cancer has spread to the leptomeninges after osimertinib has stopped working.
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Osimertinib Plus SRS/SRT for EGFR-Mutant NSCLC with Symptomatic Brain Metastases
This study tests whether adding targeted brain radiotherapy to osimertinib helps control brain metastases in adults with EGFR-mutant NSCLC and neurological symptoms.
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Osimertinib with Cyclosporine A for EGFR-mutant NSCLC
This phase II study tests whether adding cyclosporine A to osimertinib helps people with EGFR-mutant metastatic NSCLC who still have detectable tumor DNA in blood.
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Brain-avoiding proton craniospinal irradiation for leptomeningeal metastases
This study tests BRAVO pCSI, a proton therapy approach that avoids certain brain regions, to see if it helps adults with leptomeningeal metastases from solid tumors.
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Osimertinib With or Without Primary Lung Tumor Resection for EGFR-Mutant Oligometastatic NSCLC
This trial tests whether surgically removing the main lung tumor, after initial osimertinib therapy, helps people with EGFR-mutant oligometastatic non-small cell lung cancer live longer without disease progression.
How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.