Leptomeningeal Metastasis as Complication of Systemic Cancers View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2018

AUTHORS

Sophie Taillibert , Emilie Le Rhun , Marc C. Chamberlain

ABSTRACT

Leptomeningeal metastases (LM) are a result of diffuse involvement of the leptomeninges by infiltrating cancer cells. LM is identified in 4–15% of cancer patients and the most common causative cancers are breast, lung, and melanoma. The incidence of LM is increasing and may continue to increase due to improved overall survival and prolonged control of extracranial disease in patients with cancer who are often treated with systemic targeted therapies that poorly penetrate the central nervous system (CNS). The prognosis of LM remains poor partly as a consequence of late diagnosis and undertreatment. This chapter on LM illustrates the heterogeneity of the clinical presentation, new techniques under development for the detection of circulating tumor cells, and the radiological characteristics of the disease. Nevertheless the diagnosis often remains a challenge and a high index of suspicion should be maintained especially in patients with cancer and multifocal neurological signs or symptoms. LM treatment is multidisciplinary, combining intra-CSF chemotherapy, systemic therapy and radiation therapy. Treatment approaches are reviewed herein with an emphasis on the randomized trials reported in the literature. Several challenges exist regarding the evaluation of the response to treatment in LM in clinical trials and proposals of the Response Assessment in Neuro-Oncology (RANO) LM working group are discussed. The primary therapeutic goal of treatment is maintenance of neurologic function and quality of life. Recent data using novel therapies in breast cancer, lung cancer, and melanoma suggest novel targeted therapies may be effective for LM in a druggable subgroup of patients. More... »

PAGES

81-111

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  • Book

    TITLE

    Cancer Neurology in Clinical Practice

    ISBN

    978-3-319-57899-6
    978-3-319-57901-6

    Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/978-3-319-57901-6_5

    DOI

    http://dx.doi.org/10.1007/978-3-319-57901-6_5

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1091817020


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    312 schema:datePublishedReg 2018-01-01
    313 schema:description Leptomeningeal metastases (LM) are a result of diffuse involvement of the leptomeninges by infiltrating cancer cells. LM is identified in 4–15% of cancer patients and the most common causative cancers are breast, lung, and melanoma. The incidence of LM is increasing and may continue to increase due to improved overall survival and prolonged control of extracranial disease in patients with cancer who are often treated with systemic targeted therapies that poorly penetrate the central nervous system (CNS). The prognosis of LM remains poor partly as a consequence of late diagnosis and undertreatment. This chapter on LM illustrates the heterogeneity of the clinical presentation, new techniques under development for the detection of circulating tumor cells, and the radiological characteristics of the disease. Nevertheless the diagnosis often remains a challenge and a high index of suspicion should be maintained especially in patients with cancer and multifocal neurological signs or symptoms. LM treatment is multidisciplinary, combining intra-CSF chemotherapy, systemic therapy and radiation therapy. Treatment approaches are reviewed herein with an emphasis on the randomized trials reported in the literature. Several challenges exist regarding the evaluation of the response to treatment in LM in clinical trials and proposals of the Response Assessment in Neuro-Oncology (RANO) LM working group are discussed. The primary therapeutic goal of treatment is maintenance of neurologic function and quality of life. Recent data using novel therapies in breast cancer, lung cancer, and melanoma suggest novel targeted therapies may be effective for LM in a druggable subgroup of patients.
    314 schema:editor N848104966a2e482dbde862e7da2554aa
    315 schema:genre chapter
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    318 schema:isPartOf Nf558b3aa6dd7484891822310490e8c1c
    319 schema:name Leptomeningeal Metastasis as Complication of Systemic Cancers
    320 schema:pagination 81-111
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