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Case Report Open Access

Personalized therapy guided by longitudinal liquid biopsies for treatment of leptomeningeal disease from lung adenocarcinoma: A case report

  • Authors:
    • Mingyao Lai
    • Tianhao Mu
    • Ming Liu
    • Qingjun Hu
    • Juan Li
    • Tanxiao Huang
    • Yingmei Li
    • Shifu Chen
    • Linbo Cai
  • View Affiliations / Copyright

    Affiliations: Department of Oncology, Guangdong Sanjiu Brain Hospital, Guangzhou, Guangdong 510510, P.R. China, HaploX Biotechnology, Shenzhen, Guangdong 518057, P.R. China, HaploX Biotechnology, Shenzhen, Guangdong 518057, P.R. China, Department of Oncology, Guangdong Sanjiu Brain Hospital, Guangzhou, Guangdong 510510, P.R. China
    Copyright: © Lai et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 299
    |
    Published online on: May 1, 2024
       https://doi.org/10.3892/ol.2024.14432
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Abstract

Molecular-based targeted therapies have significantly benefited certain patients with cancer; however, those with leptomeningeal disease (LMD) persistently exhibit a poor prognosis and are often excluded from clinical trials. Tumor-derived cell-free (cf)DNA, found in the cerebrospinal fluid (CSF) of patients with LMD, can assist in diagnosis and tracking of disease progression. However, the utilization of CSF to direct targeted cancer therapy has yet to be extensively explored. The present study reported the case of a patient with lung adenocarcinoma and LMD who was monitored by performing a series of liquid biopsies of CSF and blood. Targeted sequencing was performed on cfDNA from the CSF and plasma, and the variant allele frequencies (VAFs) of BRAF and NRAS mutations were assessed and analyzed in conjunction with the clinical presentation of the patient. The patient then underwent serial chemotherapy, radiation therapy, immunotherapy and targeted treatment based on the results of the liquid biopsies. Upon the LMD diagnosis, a BRAF p.V600E mutation was detected in plasma cfDNA. Consequently, the patient was treated with vemurafenib and responded favorably to this consolidation treatment for 13 months. After a relapse in July 2018, both BRAF p.V600E and NRAS p.Q61K mutations were detected in CSF supernatant and sediment cell samples, suggesting drug resistance. Therefore, the treatment strategy for the patient changed to cobimetnib plus vemurafenib. Notably, the changes of VAF in the CSF supernatant samples were associated with the clinical status of the patient. The patient survived for 33 months post-LMD diagnosis. The present case report highlights the potential use of liquid biopsy in personalized therapy, as it was instrumental in informing the combinational treatment plan of the patient, which ultimately proved beneficial.
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Copy and paste a formatted citation
Spandidos Publications style
Lai M, Mu T, Liu M, Hu Q, Li J, Huang T, Li Y, Chen S and Cai L: Personalized therapy guided by longitudinal liquid biopsies for treatment of leptomeningeal disease from lung adenocarcinoma: A case report. Oncol Lett 28: 299, 2024.
APA
Lai, M., Mu, T., Liu, M., Hu, Q., Li, J., Huang, T. ... Cai, L. (2024). Personalized therapy guided by longitudinal liquid biopsies for treatment of leptomeningeal disease from lung adenocarcinoma: A case report. Oncology Letters, 28, 299. https://doi.org/10.3892/ol.2024.14432
MLA
Lai, M., Mu, T., Liu, M., Hu, Q., Li, J., Huang, T., Li, Y., Chen, S., Cai, L."Personalized therapy guided by longitudinal liquid biopsies for treatment of leptomeningeal disease from lung adenocarcinoma: A case report". Oncology Letters 28.1 (2024): 299.
Chicago
Lai, M., Mu, T., Liu, M., Hu, Q., Li, J., Huang, T., Li, Y., Chen, S., Cai, L."Personalized therapy guided by longitudinal liquid biopsies for treatment of leptomeningeal disease from lung adenocarcinoma: A case report". Oncology Letters 28, no. 1 (2024): 299. https://doi.org/10.3892/ol.2024.14432
Copy and paste a formatted citation
x
Spandidos Publications style
Lai M, Mu T, Liu M, Hu Q, Li J, Huang T, Li Y, Chen S and Cai L: Personalized therapy guided by longitudinal liquid biopsies for treatment of leptomeningeal disease from lung adenocarcinoma: A case report. Oncol Lett 28: 299, 2024.
APA
Lai, M., Mu, T., Liu, M., Hu, Q., Li, J., Huang, T. ... Cai, L. (2024). Personalized therapy guided by longitudinal liquid biopsies for treatment of leptomeningeal disease from lung adenocarcinoma: A case report. Oncology Letters, 28, 299. https://doi.org/10.3892/ol.2024.14432
MLA
Lai, M., Mu, T., Liu, M., Hu, Q., Li, J., Huang, T., Li, Y., Chen, S., Cai, L."Personalized therapy guided by longitudinal liquid biopsies for treatment of leptomeningeal disease from lung adenocarcinoma: A case report". Oncology Letters 28.1 (2024): 299.
Chicago
Lai, M., Mu, T., Liu, M., Hu, Q., Li, J., Huang, T., Li, Y., Chen, S., Cai, L."Personalized therapy guided by longitudinal liquid biopsies for treatment of leptomeningeal disease from lung adenocarcinoma: A case report". Oncology Letters 28, no. 1 (2024): 299. https://doi.org/10.3892/ol.2024.14432
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