Leptomeningeal disease (LMD) is a serious cancer complication associated with poor prognosis. Approximately 5%-25% of patients with melanoma develop LMD. Currently, no standard treatment protocol exists and very few cases have been reported. Despite ongoing advances in new therapies, treatment options for LMD remain limited. Herein, we report a case of intrathecal pembrolizumab administration in a patient with melanoma and LMD. Intrathecal pembrolizumab administration was feasible and safe at the doses tested. Drawing from this case, along with our expertise and the existing evidence on systemic immunotherapy, we propose that an immunotherapy approach involving intrathecal administration for patients with LMD from melanoma warrants additional exploration in clinical trials.
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http://dx.doi.org/10.3389/fonc.2024.1344829 | DOI Listing |
Cureus
December 2024
Internal Medicine, University of South Florida, Tampa, USA.
CNS lymphoma is a rare form of non-Hodgkin lymphoma that primarily affects the brain, spinal cord, leptomeninges, or eyes, leading to severe neurological or ophthalmological complications. This case report details a 44-year-old male with human immunodeficiency virus and diffuse large B-cell lymphoma who experienced permanent vision loss due to optic perineuritis, a rare presenting symptom indicative of underlying CNS involvement. Despite previous remission, imaging revealed focal enhancements suggesting CNS lymphoma, highlighting diagnostic and management challenges in relapsed lymphoma, especially in immunocompromised patients.
View Article and Find Full Text PDFActa Neuropathol Commun
January 2025
Department of Neurosurgery, University of California, Los Angeles, CA, USA.
The incidence of brain metastases (BrM) in patients with metastatic melanoma is reported to be 30-50% and constitutes the third most frequent BrM after breast and renal cancers. Treatment strategies including surgical resection, stereotactic radiation, and immunotherapy have improved clinical response rates and overall survival, but the changes that occur in circulating melanoma cells to promote invasion of the brain are not fully understood. To investigate brain tropism, we generated new variants of the B16 mouse melanoma model by serially passaging B16 cells through the brain of immune competent syngeneic C57BL/6 mice.
View Article and Find Full Text PDFOrphanet J Rare Dis
January 2025
Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Background: Sturge-Weber Syndrome (SWS) is a rare, sporadic neurocutaneous disorder affecting the skin, brain, and eyes, due to somatic activating mutations in GNAQ or, less commonly, GNA11 gene. It is characterized by at least two of the following features: a facial capillary malformation, leptomeningeal vascular malformation, and ocular involvement. The spectrum of clinical manifestations includes headache, seizures, stroke-like events, intellectual disability, glaucoma, facial asymmetry, gingival hyperplasia, etc.
View Article and Find Full Text PDFEcancermedicalscience
October 2024
Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai 400012, India.
Spread of lung cancer to the leptomeninges is rare and difficult to treat. Standard therapy comprises CNS-penetrant targeted agents with or without intrathecal chemotherapy. We performed a retrospective analysis of 16 patients with advanced NSCLC and leptomeningeal disease treated with intrathecal pemetrexed 50 mg.
View Article and Find Full Text PDFCancer Treat Rev
January 2025
Division of Hematology and Oncology, University of Virginia Comprehensive Cancer Center, Charlottesville, VA, United States. Electronic address:
Background: Trastuzumab deruxtecan (T-DXd) has shown promising activity in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) and central nervous system (CNS) involvement. In this updated meta-analysis, we explore the effectiveness of T-DXd in a large subset of patients with HER2-positive BC and CNS disease.
Methods: A systematic search was made on September 16th, 2024, for studies investigating T-DXd in the scenario of HER2-positive BC and brain metastases (BMs) and/or leptomeningeal disease (LMD).
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