Breast Cancer Research and Treatment

, Volume 131, Issue 1, pp 343–346

Resolution of extensive leptomeningeal metastasis and clinical spinal cord compression from breast cancer using weekly docetaxel chemotherapy

Authors

  • Bethany Wilson
    • Department of Internal MedicineUniversity of Kentucky and Markey Cancer Center
  • Christy Sapp
    • Department of Internal MedicineUniversity of Kentucky and Markey Cancer Center
  • Ghadeer Abdeen
    • King Hussein Cancer Center
  • Atheel Kamona
    • King Hussein Cancer Center
    • Department of Internal MedicineUniversity of Kentucky and Markey Cancer Center
Brief Report

DOI: 10.1007/s10549-011-1825-3

Cite this article as:
Wilson, B., Sapp, C., Abdeen, G. et al. Breast Cancer Res Treat (2012) 131: 343. doi:10.1007/s10549-011-1825-3
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Abstract

Metastatic breast cancer to the leptomeninges is a late event in the disease course and is associated with significant morbidity and a grave prognosis. Treatment typically involves direct intrathecal injection of chemotherapy into the cerebrospinal fluid compartment since systemic chemotherapy penetrates poorly to the central nervous system. Here we report an interesting clinical observation involving a patient presenting with leptomeningeal spread of breast cancer causing extensive spinal cord compression with obliteration of the subarachnoid space, thus precluding the use of direct intrathecal chemotherapy. We administered systemic chemotherapy using weekly docetaxel with complete radiographic resolution of her disease and recovery from clinical spinal cord compression. While this is a single clinical observation, weekly administration of docetaxel in this circumstance may have been associated with improved drug “escape” into the central nervous system and better antitumor effect. Because leptomeningeal disease is typically a late event in metastatic breast cancer, resistance to therapeutic intervention may reflect intrinsically resistant disease in the setting of extensive prior therapy rather than a routine problem with systemic drug delivery to the CNS. Studying patterns of disease relapse in patients who had received adjuvant weekly taxanes may provide insights into this hypothesis.

Keywords

Breast cancerLeptomeningeal carcinomatosisChemotherapyDocetaxel

Copyright information

© Springer Science+Business Media, LLC. 2011