TY - JOUR
T1 - Leptomeningeal Metastases in Melanoma Patients
T2 - An Update on and Future Perspectives for Diagnosis and Treatment
AU - Steininger, Julian
AU - Gellrich, Frank Friedrich
AU - Engellandt, Kay
AU - Meinhardt, Matthias
AU - Westphal, Dana
AU - Beissert, Stefan
AU - Meier, Friedegund
AU - Glitza Oliva, Isabella C.
N1 - Funding Information:
F.M. received travel support and/or speaker’s fees and/or advisor’s honoraria by Novartis, Roche, BMS, MSD, Pierre Fabre, Sanofi, and Immunocore and research funding from Novartis and Roche. I.C.G.O. consulted for Bristol Myers Squibb, Array, Novartis, and Sintetica and has been the PI of research funding to M.D. Anderson by Bristol Myers Squibb, Merck, and Pfizer. I.C.G.O. was also funded by the M.D. Anderson Cancer Melanoma Moonshot and P50CA221703. The remaining authors state no conflict of interest.
Publisher Copyright:
© 2023 by the authors.
PY - 2023/7
Y1 - 2023/7
N2 - Leptomeningeal disease (LMD) is a devastating complication of cancer with a particularly poor prognosis. Among solid tumours, malignant melanoma (MM) has one of the highest rates of metastasis to the leptomeninges, with approximately 10–15% of patients with advanced disease developing LMD. Tumour cells that metastasise to the brain have unique properties that allow them to cross the blood–brain barrier, evade the immune system, and survive in the brain microenvironment. Metastatic colonisation is achieved through dynamic communication between metastatic cells and the tumour microenvironment, resulting in a tumour-permissive milieu. Despite advances in treatment options, the incidence of LMD appears to be increasing and current treatment modalities have a limited impact on survival. This review provides an overview of the biology of LMD, diagnosis and current treatment approaches for MM patients with LMD, and an overview of ongoing clinical trials. Despite the still limited efficacy of current therapies, there is hope that emerging treatments will improve the outcomes for patients with LMD.
AB - Leptomeningeal disease (LMD) is a devastating complication of cancer with a particularly poor prognosis. Among solid tumours, malignant melanoma (MM) has one of the highest rates of metastasis to the leptomeninges, with approximately 10–15% of patients with advanced disease developing LMD. Tumour cells that metastasise to the brain have unique properties that allow them to cross the blood–brain barrier, evade the immune system, and survive in the brain microenvironment. Metastatic colonisation is achieved through dynamic communication between metastatic cells and the tumour microenvironment, resulting in a tumour-permissive milieu. Despite advances in treatment options, the incidence of LMD appears to be increasing and current treatment modalities have a limited impact on survival. This review provides an overview of the biology of LMD, diagnosis and current treatment approaches for MM patients with LMD, and an overview of ongoing clinical trials. Despite the still limited efficacy of current therapies, there is hope that emerging treatments will improve the outcomes for patients with LMD.
KW - CNS microenvironment
KW - intrathecal therapy
KW - leptomeningeal carcinomatosis
KW - leptomeningeal disease
KW - leptomeningeal metastases
KW - melanoma
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U2 - 10.3390/ijms241411443
DO - 10.3390/ijms241411443
M3 - Review article
C2 - 37511202
AN - SCOPUS:85165985715
SN - 1661-6596
VL - 24
JO - International journal of molecular sciences
JF - International journal of molecular sciences
IS - 14
M1 - 11443
ER -