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Induction of Leptomeningeal Cells Modification Via Intracisternal Injection
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Leptomeningeal Metastases.

Jerome J Graber1, Santosh Kesari2

  • 1Department of Neurology, Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment, Swedish Neuroscience Institute, Seattle, WA, 98122-4470, USA. jerome.graber@swedish.org.

Current Treatment Options in Oncology
|January 25, 2018
PubMed
Summary

Leptomeningeal metastases treatment is improving with targeted therapies and advanced radiation. Understanding cancer

Keywords:
Brain metastasesBreast cancerChemotherapyLeptomeningeal metastasesLung cancerMelanoma

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Area of Science:

  • Neuro-oncology
  • Medical oncology

Background:

  • Leptomeningeal metastases (LM) present a significant challenge in advanced cancer care.
  • Treatment options for LM have historically been limited, with poor prognoses.
  • Evolving understanding of cancer biology offers new therapeutic avenues.

Purpose of the Study:

  • To review current and emerging treatment strategies for leptomeningeal metastases.
  • To highlight the importance of molecular subtyping in guiding treatment decisions.
  • To discuss the limitations and potential of various therapeutic modalities.

Main Methods:

  • Review of current literature on leptomeningeal metastases treatment.
  • Discussion of molecular profiling in central nervous system (CNS) disease.
  • Analysis of intrathecal therapies, radiosurgery, and proton therapy.

Main Results:

  • Treatment options for LM are expanding, offering improved tolerability and efficacy.
  • Molecular subtypes, particularly in breast and lung cancer, can influence treatment response.
  • Intrathecal therapies are limited by CSF flow dynamics and disease burden.
  • Focal radiosurgery and proton craniospinal radiation remain effective for symptomatic relief.

Conclusions:

  • Personalized medicine approaches, guided by molecular subtypes, are crucial for LM management.
  • Physicians must consider CNS-specific molecular differences and CSF flow dynamics.
  • Further clinical studies are needed to establish optimal treatment algorithms for LM.