Objective:

To compare the molecular profiles of cerebrospinal fluid (CSF) between patients with concurrent brain parenchymal and meningeal metastasis and those with meningeal metastasis only, highlighting the clinical significance of these differences.

Key Findings:

• Lung cancer has the highest incidence of brain metastases, with significant differences in survival rates between BM and MM.
• CSF is a more reliable source for genetic profiling of intracranial lesions compared to circulating tumor DNA (ctDNA) in blood.
• Limited comparative studies exist on the genomic differences between BM and MM, with specific genomic alterations identified.

Interpretation:

Understanding the molecular differences in CSF between BM and MM may lead to improved treatment strategies and identification of biomarkers for targeted therapies, potentially enhancing patient outcomes.

Limitations:

• Most existing studies focus on either BM or MM, lacking comparative analyses.
• Detection of ctDNA in plasma has limited sensitivity for intracranial lesions due to the blood-brain barrier.
• Sample size may limit the generalizability of findings and potential biases in patient selection.

Conclusion:

The study aims to enhance the characterization of CSF variants in different metastatic patterns, potentially guiding more precise treatment approaches for patients with LUAD, and identifying specific biomarkers for clinical use.