This discussion will focus on defining the standard of care for neoplastic meningitis, including: What is the role of radiation therapy? What are first-line pharmacotherapeutic agents? Is combination therapy useful? What is the role of corticosteroids?
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http://dx.doi.org/10.1586/14737175.4.4.S11 | DOI Listing |
Clin Nucl Med
January 2025
From the Department of Nuclear Medicine, University of Health Sciences, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey.
Neoplastic meningitis, also known as leptomeningeal metastases, is a rare clinical entity seen in less than 1%-2% of primary nervous system tumors. Diagnosis of leptomeningeal metastases is difficult and is achieved by cytologic evidence of malignant cells in cerebrospinal fluid, or demonstration of radiologic abnormality. 18F-FDG PET/CT can detect leptomeningeal metastases before anatomical changes.
View Article and Find Full Text PDFNeurosurgery
January 2025
Department of Neurosurgery, Hershey Medical Center, Hershey, Pennsylvania, USA.
Background And Objectives: Administration of intraventricular chemotherapy through Ommaya reservoir is indicated for certain forms of leptomeningeal disease. However, ventricular reservoirs carry a substantial risk of infection. The conventional approach to managing reservoir-associated infections involves removal of the reservoir and systemic antibiotic therapy, but this strategy necessitates additional procedures to remove and subsequently replace the device.
View Article and Find Full Text PDFPLOS Glob Public Health
December 2024
Laboratory Biology, Engineering and Imaging for Ophthalmology, Health Innovation Campus, Faculty of Medicine, University Jean Monnet, Saint-Etienne, France.
Corneal graft (keratoplasty) is the most common allograft in the world, but the imbalance between the number of donors and the number of patients waiting for transplants is abysmal on a global scale and varies enormously from one country to another. The risk of transmission of systemic diseases from donor to recipient is demonstrably low. In over 50 years and an estimated 2.
View Article and Find Full Text PDFCancer Chemother Pharmacol
December 2024
Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford Cancer Institute, Stanford, USA.
Progressive leptomeningeal metastases (LM) are associated with intractable neurological symptoms and a poor prognosis, and effective treatment options are limited. Intrathecal (IT) pemetrexed has been shown to confer clinical benefit in lung adenocarcinoma, yet our understanding of the efficacy and safety of the treatment is limited. We report a patient with a long-standing history of leptomeningeal disease due to ALK-positive adenocarcinoma of the lung, previously controlled by increased doses of lorlatinib (125 mg/day).
View Article and Find Full Text PDFJCO Precis Oncol
December 2024
Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA.
Purpose: Leptomeningeal disease (LMD) is associated with significant morbidity and mortality for metastatic non-small cell lung cancer (NSCLC). We describe our clinical experience in evaluating the use of cerebrospinal fluid (CSF)-derived circulating tumor cells (CTCs) for the diagnosis of LMD and the detection of genomic alterations in CSF cell-free DNA (cfDNA).
Methods: Patients with NSCLC who had CSF collection as part of routine clinical care for suspected LMD were included in the study.
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