Circulating tumor cells (CTC) in cerebrospinal uid (CSF) are a quantitative diagnostic tool for leptomeningeal metastases (LM) from solid tumors, but their prognostic signi cance is unclear. Our objective was to evaluate CSF-CTC quanti cation in predicting outcomes in LM. MethodsThis is a single institution retrospective study of patients with solid tumors who underwent CSF-CTC quanti cation using the CellSearch® platform between 04/2016-06/2019. Information on neuroaxis imaging, CSF results, and survival was collected. LM was diagnosed by MRI and/or CSF cytology. Survival analyses were performed using multivariable Cox proportional hazards modeling, and CSF-CTC splits associated with survival were identi ed through recursive partitioning analysis. ResultsOut of 290 patients with CNS metastases, we identi ed a cohort of 101 patients with newly diagnosed LM. In this group, CSF-CTC count (median 200 CTCs/3ml) predicted survival continuously (HR = 1.005, 95% CI: 1.002-1.009, p = 0.0027), and the risk of mortality doubled (HR = 2.84, 95% CI: 1.45-5.56, p = 0.0023) at the optimal cutoff of ≥ 61 CSF-CTCs/3ml. Neuroimaging ndings of LM (assessed by 3 independent neuroradiologists) were associated with a higher CSF-CTC count (median CSF-CTCs range 1.5-4 for patients without radiographic LM vs 200 for patients with radiographic LM, p<0.001), but did not predict survival. ConclusionOur data shows that CSF-CTCs quanti cation predicts survival in newly diagnosed LM, and outperforms neuroimaging. CSF-CTC analysis can be used as a prognostic tool in patients with LM and provides quantitative assessment of disease burden in the CNS compartment.

Diversifying the future cancer research workforce requires that students engage in cancer research, persist in paths toward science, technology, engineering, mathematics, and medicine (STEMM) fields, and choose cancer research careers. The Summer Clinical Oncology Research Experience (SCORE) Program at Memorial Sloan Kettering, designed in 2010 to engage undergraduate (U) and post-baccalaureate (PB) students from diverse backgrounds in cancer research, is an 8-week summer program pairing an U or PB student with a faculty mentor to conduct cancer research. We report demographics and career paths for 2010–2019 SCORE students. Of 116 students, 112 (97%) attended public universities, and 75 (64%) were in their first 2 years of college. Race/ethnicity was Black/African American, 20 (17%); Hispanic/Latinx, 15 (13%); multiracial, five (4%); Asian, 40 (34%); White/Caucasian, 36 (31%). A total of 112 (97%) identified as female; 47 (41%) were first-generation college students, and 85 (73%) were from immigrant families. As of 2021, 114 (98%) persisted in paths toward STEMM careers: 44 (38%) medical school (MS) students, 14 (12%) residents, two (2%) practicing physicians, 12 (10%) pursuing non-MD STEMM advanced degrees, 21 (18%) working in non-MD STEMM fields, 17 (15%) applying to MS, and 4 (3%) U science majors. Cancer research participation significantly increased from 5% pre- to 84% post-SCORE. A total of 63/116 (54%) students subsequently co-authored 152 peer-reviewed publications, including 105 (69%) in oncology. SCORE engaged underrepresented U and PB students in cancer research, and 98% of these students persisted in paths toward STEMM careers. Long-term follow-up is needed to assess the enduring engagement of these underrepresented students in cancer research.