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Advances in the Diagnosis and Treatment of Leptomeningeal Disease

  • Neuro-Oncology (P.Y. Wen, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Leptomeningeal disease (LMD) is a rare, late complication of systemic cancer and is associated with significant neurological morbidity and high mortality. Here we provide an overview of this condition, summarizing key recent research findings and clinical practice trends in its diagnosis and treatment. We also review current clinical trials for LMD.

Recent Findings

Improved molecular diagnostic tools are in development to enable more sensitive detection of LMD, including circulating tumor cells and circulating tumor DNA. The use of targeted and CNS-penetrant therapeutics has shown survival improvements with tyrosine kinase inhibitors, antibody–drug conjugates, and select chemotherapy. However, these studies have primarily been phase I/II and retrospective analyses. There remains a dearth of clinical trials that include LMD patients.

Summary

The combination of patient-specific molecular information and novel therapeutic approaches holds significant promise for improving outcomes in patients with LMD.

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Authors and Affiliations

  1. Department of Translational Neurosciences, Pacific Neuroscience Institute/Saint John’s Cancer Institute, 2200 Santa Monica Blvd, Santa Monica, CA, 90404, USA

    Akanksha Sharma

  2. Department of Neurosurgery and Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA

    Justin T. Low

  3. Malnati Brain Tumor Institute and the Robert H. Lurie Comprehensive Cancer Center, Department of Neurology, The Feinberg School of Medicine/Northwestern University, Chicago, IL, USA

    Priya Kumthekar

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  1. Akanksha Sharma
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Sharma, A., Low, J.T. & Kumthekar, P. Advances in the Diagnosis and Treatment of Leptomeningeal Disease. Curr Neurol Neurosci Rep 22, 413–425 (2022). https://doi.org/10.1007/s11910-022-01198-3

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