Pharmacotherapy for leptomeningeal disease in breast cancer

Bartsch, Rupert; Jerzak, Katarzyna J.; Larrouquere, Louis; Müller, Volkmar; Le Rhun, Emilie

doi:10.1016/j.ctrv.2023.102653

Cited by 5 publications

(3 citation statements)

References 61 publications

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“…As this technique is not available in most countries and given the limited data available, there was no voting on the topic. To date, there are a lack of high-quality clinical trial data supporting the use of specific systemic therapies in LMD despite some case series and retrospective cohort studies [ 213 ]. Patients, including those with a preserved general performance status at diagnosis of LMD, are often excluded from clinical trials in breast cancer; this is presumably due to the risk of rapidly progressing disease and short life expectancy [ 214 , 215 ].…”

Section: Methodsmentioning

confidence: 99%

“…The choice of systemic therapy for LMD should consider the breast cancer subtype and previous treatments. Systemic regimens with reported benefit include capecitabine, platinum and platinum-based combinations, anthracyclines and endocrine-based therapy [ 213 ]. Albeit in very small case series, there are some efficacy data in LMD for capecitabine monotherapy, the combination capecitabine + trastuzumab + tucatinib [ 105 , 216 ] and for T-DXd [ 217 ].…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7)

Cardoso,

Paluch-Shimon,

Schumacher-Wulf

et al. 2024

The Breast

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7)

Cardoso,

Paluch-Shimon,

Schumacher-Wulf

et al. 2024

The Breast

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“…(8-10) Effective treatment methods for LMD are lacking, although tentative results from novel systemic therapies for breast cancer, non-small cell lung cancer (NSCLC) and melanoma show potential. (11)(12)(13)(14) This makes it essential to identify patients at risk of developing LMD and explore optimal treatment strategies to decrease the incidence of LMD.…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with leptomeningeal metastases after postoperative stereotactic radiotherapy for brain metastases

Crouzen,

Petoukhova,

Hakstege

et al. 2024

Preprint

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Introduction: Neurosurgical resection is the standard treatment for large brain metastases (BMs). Perioperative tumor spill is an important complication which is theorized to contribute to leptomeningeal disease (LMD). Postoperative stereotactic radiotherapy (SRT) is used to improve local control, but does not always prevent LMD. This study aims to identify patients at increased risk of developing LMD after postoperative SRT. Methods: We included 147 patients who underwent resection and SRT for BMs. Univariable and multivariable Cox regression analyses were used to assess associations of LMD with various patient characteristics. Results: Median survival after postoperative SRT was 14 months (IQR 6-30) with 3-year actuarial survival rate of 21%. LMD was diagnosed in 21/147 patients (14%; 3-year actuarial rate 26%). Patients with resected cerebellar metastases were more likely to develop LMD than those with cerebral metastases (HR 4.24, 95% CI 1.11-16.3, P = 0.035). Incidence of LMD for cerebellar metastases was 9/40 (23%; 3-year actuarial rate 46%) and 12/107 (11%; 3-year actuarial rate 17%) in cerebral metastases. Median survival after LMD diagnosis was 4 months. Conclusion: Patients with a resected cerebellar BM were at increased risk to develop LMD compared to patients with cerebral BMs. Survival after LMD was poor, highlighting the need for effective preventative strategies.

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Interdisziplinäre Therapie von Hirnmetastasen

Bernhardt,

Krieg,

Müller

et al. 2024

Onkologie

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ZusammenfassungBei Patientinnen mit einem metastasierten Mammakarzinom zeigt sich eine steigende Inzidenz zerebraler Metastasen bei Fortschritten in der systemischen Therapie. Bei Metastasen des zentralen Nervensystems (ZNS) ist in den meisten Fällen eine lokale Therapie indiziert. Eine operative Therapie kommt bei symptomatischen Metastasen, singulären Metastasen oder zur Gewinnung einer Histologie infrage. Eine Radiatio der ZNS-Metastasen sollte nach Möglichkeit stereotaktisch erfolgen. Bei multiplen Hirnmetastasen bzw. im Rezidiv kann eine Ganzhirnbestrahlung durchgeführt werden, die mit kognitiven Einschränkungen assoziiert sein kann. In Einzelfällen kann bei asymptomatischen Metastasen und Wechsel der systemischen Therapie eine lokale Behandlung aufgeschoben werden, insbesondere wenn eine stereotaktische Bestrahlung nicht möglich ist. Erste Studiendaten für Patientinnen mit Hirnmetastasen liegen vor, jedoch besteht großer Bedarf an klinischer und translationaler Forschung.

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Pharmacotherapy for leptomeningeal disease in breast cancer

Cited by 5 publications

References 61 publications

6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7)

6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7)

Risk factors associated with leptomeningeal metastases after postoperative stereotactic radiotherapy for brain metastases

Interdisziplinäre Therapie von Hirnmetastasen

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