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Emerging innovative treatments for leptomeningeal metastatic tumors

Nobuhiko Kanaya1, Khalid Shah2

  • 1Center for Stem Cell and Translational Immunotherapy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan.

Trends in Molecular Medicine
|November 19, 2025
PubMed

Insights

Leptomeningeal metastasis (LM) treatments are improving with targeted therapies, immunotherapies, and advanced drug delivery. These innovations offer new hope for patients with this advanced cancer complication.

Area of Science:

  • Oncology
  • Neurology
  • Cancer Research

Background:

  • Leptomeningeal metastasis (LM) is a severe complication of advanced solid tumors.
  • Current treatments for LM have limited efficacy and significant toxicity.
  • Poor drug penetration into the central nervous system hinders conventional therapy.

Purpose of the Study:

  • To review recent advances in the management of leptomeningeal metastasis.
  • To highlight novel therapeutic strategies and their clinical impact.
  • To discuss the evolving landscape of LM treatment.

Main Methods:

  • Review of preclinical and clinical studies on LM therapies.
  • Analysis of advancements in targeted therapy, immunotherapy, and drug delivery.
  • Examination of novel agents and treatment modalities.

Main Results:

  • Brain-penetrant agents demonstrate improved outcomes in LM.
  • Intrathecal administration of antibodies and immune checkpoint inhibitors (ICIs) expands treatment options.
  • Immunotherapies like CAR-T cells and stem cell therapies show promise against LM's microenvironment.

Conclusions:

  • Recent innovations are transforming LM management.
  • New therapeutic approaches offer renewed potential for LM patients.
  • The review underscores a paradigm shift in treating leptomeningeal metastasis.
Keywords:
CAR T-cell therapyimmunotherapyintrathecal therapyleptomeningeal metastasistargeted therapy

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