Leveraging molecular and immune-based therapies in leptomeningeal metastases Review
| Authors: | Wilcox, J. A.; Boire, A. A. |
| Review Title: | Leveraging molecular and immune-based therapies in leptomeningeal metastases |
| Abstract: | Leptomeningeal metastases represent an aggressive stage of cancer with few durable treatment options. Improved understanding of cancer biology, neoplastic reliance on oncogenic driver mutations, and complex immune system interactions have resulted in an explosion in cancer-directed therapy in the last two decades to include small molecule inhibitors and immune checkpoint inhibitors. Most of these therapeutics are underexplored in patients with leptomeningeal metastases, limiting extrapolation of extracranial and even intracranial efficacy outcomes to the unique leptomeningeal space. Further confounding our interpretation of drug activity in the leptomeninges is an incomplete understanding of drug penetration through the blood-cerebrospinal fluid barrier of the choroid plexus. Nevertheless, a number of retrospective studies and promising prospective trials provide evidence of leptomeningeal activity of several small molecule and immune checkpoint inhibitors and underscore potential areas of further therapeutic development for patients harboring leptomeningeal disease. |
| Keywords: | capecitabine; progression; cell lung-cancer; growth-factor receptor; central-nervous-system; cerebrospinal-fluid; multicenter phase-ii; her2-positive breast-cancer; blood-brain-barrier; lapatinib plus; trastuzumab emtansine t-dm1; non-cns |
| Journal Title: | CNS Drugs |
| Volume: | 37 |
| Issue: | 1 |
| ISSN: | 1172-7047 |
| Publisher: | Adis International Ltd |
| Date Published: | 2023-01-01 |
| Start Page: | 45 |
| End Page: | 67 |
| Language: | English |
| ACCESSION: | WOS:000894728000001 |
| DOI: | 10.1007/s40263-022-00975-5 |
| PROVIDER: | Clarivate Analytics Web of Science |
| PROVIDER: | wos |
| PMCID: | PMC9829628 |
| PUBMED: | 36474108 |
| Notes: | Review -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Adrienne Boire -- Source: Wos |
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