Treatment of Leptomeningeal Metastases
Document type :
Article dans une revue scientifique: Article original
Permalink :
Title :
Treatment of Leptomeningeal Metastases
Author(s) :
Le Rhun, Emilie [Auteur]
Universität Zürich [Zürich] = University of Zurich [UZH]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192
Weller, M. [Auteur]
Universität Zürich [Zürich] = University of Zurich [UZH]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192
Weller, M. [Auteur]
Journal title :
Central Nervous System Metastases
Abbreviated title :
-
Volume number :
-
Pages :
301-311
Publication date :
2020-09-05
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
The goal of this chapter is to review the therapeutic approaches to patients with leptomeningeal metastases (LM). The goal of LM treatment is to prolong survival, to maintain quality of life, and to delay neurological ...
Show more >The goal of this chapter is to review the therapeutic approaches to patients with leptomeningeal metastases (LM). The goal of LM treatment is to prolong survival, to maintain quality of life, and to delay neurological deterioration. Intracerebrospinal fluid (CSF) pharmacotherapy, systemic pharmacotherapy, and mostly focal radiotherapy are the key treatment modalities. Until recently, no high-level evidence for the use of intra-CSF therapy in LM was available. Recently, a significant improvement of progression-free survival related to LM has been reported in a randomized phase III trial in breast cancer patients with LM using liposomal cytarabine in combination with systemic therapy compared with systemic treatment alone. The safety and efficacy of new, mostly targeted agents, such as trastuzumab, upon intra-CSF administration are currently being explored. Targeted treatments, such as anti-human epidermal growth factor receptor (HER) 2 treatments for breast cancer, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) for non-small-cell lung cancer (NSCLC), or BRAF-targeted agents for melanoma, and immunotherapy for lung cancer and melanoma have an emerging role in the management of this condition. Radiotherapy should be given to relieve clinical symptoms and signs and for the treatment of meningeal nodules. Whole-brain radiotherapy should be avoided. Individualized supportive care strategies involving patients and caregivers are essential during the course of the disease.Show less >
Show more >The goal of this chapter is to review the therapeutic approaches to patients with leptomeningeal metastases (LM). The goal of LM treatment is to prolong survival, to maintain quality of life, and to delay neurological deterioration. Intracerebrospinal fluid (CSF) pharmacotherapy, systemic pharmacotherapy, and mostly focal radiotherapy are the key treatment modalities. Until recently, no high-level evidence for the use of intra-CSF therapy in LM was available. Recently, a significant improvement of progression-free survival related to LM has been reported in a randomized phase III trial in breast cancer patients with LM using liposomal cytarabine in combination with systemic therapy compared with systemic treatment alone. The safety and efficacy of new, mostly targeted agents, such as trastuzumab, upon intra-CSF administration are currently being explored. Targeted treatments, such as anti-human epidermal growth factor receptor (HER) 2 treatments for breast cancer, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) for non-small-cell lung cancer (NSCLC), or BRAF-targeted agents for melanoma, and immunotherapy for lung cancer and melanoma have an emerging role in the management of this condition. Radiotherapy should be given to relieve clinical symptoms and signs and for the treatment of meningeal nodules. Whole-brain radiotherapy should be avoided. Individualized supportive care strategies involving patients and caregivers are essential during the course of the disease.Show less >
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
Inserm
CHU Lille
Inserm
CHU Lille
Submission date :
2023-12-13T05:35:51Z
2024-01-22T15:27:53Z
2024-01-22T15:27:53Z