Leptomeningeal metastases: New opportunities in the modern era Review
| Authors: | Wilcox, J. A.; Li, M. J.; Boire, A. A. |
| Review Title: | Leptomeningeal metastases: New opportunities in the modern era |
| Abstract: | Leptomeningeal metastases arise from cancer cell entry into the subarachnoid space, inflicting significant neurologic morbidity and mortality across a wide range of malignancies. The modern era of cancer therapeutics has seen an explosion of molecular-targeting agents and immune-mediated strategies for patients with breast, lung, and melanoma malignancies, with meaningful extracranial disease control and improvement in patient survival. However, the clinical efficacy of these agents in those with leptomeningeal metastases remains understudied, due to the relative rarity of this patient population, the investigational challenges associated with studying this dynamic disease state, and brisk disease pace. Nevertheless, retrospective studies, post hoc analyses, and small prospective trials in the last two decades provide a glimmer of hope for patients with leptomeningeal metastases, suggesting that several cancer-directed strategies are not only active in the intrathecal space but also improve survival against historical odds. The continued development of clinical trials devoted to patients with leptomeningeal metastases is critical to establish robust efficacy outcomes in this patient population, define drug pharmacokinetics in the intrathecal space, and uncover new avenues for treatment in the face of leptomeningeal therapeutic resistance. © 2022, The Author(s). |
| Keywords: | treatment outcome; retrospective studies; prospective study; prospective studies; pathology; retrospective study; cerebrospinal fluid; meningeal neoplasms; meningioma; brain metastases; leptomeningeal metastases; leptomeningeal disease; central nervous system metastases; humans; human; craniospinal radiation; intrathecal therapy |
| Journal Title: | Neurotherapeutics |
| Volume: | 19 |
| Issue: | 6 |
| ISSN: | 1933-7213 |
| Publisher: | The American Society for Experimental Neurotherapeutics, Inc |
| Date Published: | 2022-10-01 |
| Start Page: | 1782 |
| End Page: | 1798 |
| Language: | English |
| DOI: | 10.1007/s13311-022-01261-4 |
| PUBMED: | 35790709 |
| PROVIDER: | scopus |
| PMCID: | PMC9723010 |
| DOI/URL: | |
| Notes: | Review -- Export Date: 3 January 2023 -- Source: Scopus |
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