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A combination therapy consisting of pemetrexed (an antifolate antimetabolite), furmonertinib (a third-generation EGFR tyrosine kinase inhibitor), and bevacizumab (a recombinant humanized monoclonal IgG1 antibody that inhibits VEGF). This combination is being investigated for the treatment of EGFR-mutant non-small cell lung cancer (NSCLC) with leptomeningeal metastases, particularly after resistance to third-generation EGFR-TKIs. Pemetrexed may be administered intrathecally to increase intracranial drug concentrations, while high-dose furmonertinib (160mg daily) is used systemically along with bevacizumab (5-7.5 mg/kg) to target both the primary tumor and metastases.
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