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Leptomeningeal Disease: Current Approaches and Future Directions
Ugur Sener1,2, Jessica A Wilcox3, Adrienne A Boire4,5
1Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Current Neurology and Neuroscience Reports
|March 18, 2025
Summary
Leptomeningeal disease (LMD) presents significant challenges, but novel diagnostics and advanced treatments like proton radiation and targeted therapies offer improved outcomes for patients with this condition.
Area of Science:
- Neuro-oncology
- Cancer Metastasis
- Immunotherapy
Background:
- Leptomeningeal disease (LMD) involves cancer spread to brain/spinal cord membranes.
- LMD is linked to high symptom burden and poor survival (2-5 months).
- Conventional treatments show limited efficacy for LMD.
Purpose of the Study:
- Review diagnostic and treatment challenges in LMD.
- Highlight advances in LMD understanding and management.
- Discuss emerging therapeutic strategies for LMD.
Main Methods:
- Discuss novel cerebrospinal fluid (CSF) analysis techniques.
- Review clinical trial data for proton craniospinal radiation.
- Examine emerging targeted therapeutics and combinatorial approaches.
Main Results:
- Novel CSF analyses (circulating tumor cells, cell-free DNA) improve diagnostics.
- Proton craniospinal radiation shows efficacy for neuroaxis treatment.
- Targeted therapeutics demonstrate potential for durable survival benefit.
Conclusions:
- Advances in LMD diagnostics and therapeutics are shifting the treatment paradigm.
- Novel therapies and combinations are expected to improve patient outcomes.
- Further research into LMD pathophysiology and treatment is crucial.
Keywords:
Central nervous system metastasesCerebrospinal fluidCraniospinal radiationIntrathecal therapyLeptomeningeal diseaseLeptomeningeal metastasesMore Related Videos
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