Skip to main content

Advertisement

SpringerLink
Log in

Liposomal cytarabine in neoplastic meningitis from primary brain tumors: a single institutional experience

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Neoplastic meningitis (NM) is diagnosed in 1–2 % of patients with primary brain tumors. Standard treatment of NM includes single-agent or combination chemotherapy, with compounds such as methotrexate, thiotepa, and cytarabine (Ara-C) or its injectable, sustained-release formulation Depocyte®. In this Report, we reported the data of efficacy and tolerability of an intrathecal Depocyte® regimen for patients presenting with NM from primary brain tumors. We described 12 patients with NM confirmed at magnetic resonance imaging (MRI) and with a positive cerebrospinal fluid (CSF) cytology. Patients were treated with repeated courses of intrathecal Depocyte® (once every 2 weeks for 1 month of induction therapy and as consolidation therapy on a monthly base in responding patients). Twelve patients (10 males and 2 females) were treated by our Institution. The diagnosis of primitive brain tumor was medulloblastoma in six patients, germinoma in two patients, pylocitic astrocytomas with spongioblastic aspects, teratocarcinoma, meningeal melanoma, and ependimoma in the other four patients. The total number of Depocyte® cycles ranged from one to nine. In 7/12 patients, there was clinical and/or radiological response after Depocyte®, and the toxicity was moderate and transient, mainly due to the lumbar puncture procedure. In the two patients with germinoma, we observed a normalization of MRI Imaging and negativization of CSF with disappearance of the tumor cells. OS was 180 days (range 20–300, CI 95 %).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Chamberlain MC (2008) Neoplastic meningitis. Oncologist 13:967–977

    Article  PubMed  Google Scholar 

  2. Bruna J, Gonzalez L, Miro′ J et al (2009) Leptomeningeal carcinomatosis. Cancer 115:381–389

    Article  PubMed  Google Scholar 

  3. Silvani A, Caroli M, Gaviani P, Fetoni V, Merli R, Riva M, De Rossi M, Imbesi F, Salmaggi A (2013) Neoplastic meningitis from solid tumors: a prospective clinical study in Lombardia and a literature review on therapeutic approaches. J Drug Deliv 2013:147325

    Article  PubMed  CAS  Google Scholar 

  4. Glantz MJ, Van Horn A, Fisher R, Chamberlain MC (2010) Route of intracerebrospinal fluid chemotherapy administration and efficacy of therapy in neoplastic meningitis. Cancer 116:1947–1952

    Article  PubMed  Google Scholar 

  5. Rueda Domínguez A, Olmos Hidalgo D, Viciana Garrido R, Torres Sánchez E (2005) Liposomal cytarabine (DepoCyte) for the treatment of neoplastic meningitis. Clin Transl Oncol 7(6):232–238

    Article  PubMed  Google Scholar 

  6. Glantz MJ, Jaeckle KA, Chamberlain MC et al (1999) A randomized controlled trial comparing intrathecal sustained-release cytarabine (DepoCyt) to intrathecal methotrexate in patients with neoplastic meningitis from solid tumors. Clin Cancer Res 5:3394–3402

    PubMed  CAS  Google Scholar 

  7. Chamberlain MC (1998) Leptomeningeal metastases: a review of evaluation and treatment. J Neurooncol 37:271–284

    Article  PubMed  CAS  Google Scholar 

  8. Chamberlain MC (2006) Lymphomatous meningitis in primary central nervous system lymphoma. Neurosurg Focus 21(5):E6

    Article  PubMed  Google Scholar 

  9. Strik H, Prömmel P (2010) Diagnosis and individualized therapy of neoplastic meningitis. Expert Rev Anticancer Ther 10(7):1137–1148

    Article  PubMed  Google Scholar 

  10. Gleissner B, Chamberlain MC (2006) Neoplastic meningitis. Lancet Neurol 5(5):443–452

    Article  PubMed  Google Scholar 

  11. Elliott P, Ku NN, Werner MH (1995) Neoplastic meningitis with normal neurological findings magnetic resonance imaging results. J Neuroimaging 5(4):233–236

    PubMed  CAS  Google Scholar 

  12. Glantz MJ, Cole BF, Recht L et al (1998) High-dose intravenous methotrexate for patients with nonleukemic leptomeningeal cancer: is intrathecal chemotherapy necessary? J Clin Oncol 16:1561–1567

    PubMed  CAS  Google Scholar 

  13. Boogerd W, Bent MJ, Koehler PJ et al (2004) The relevance of intraventricular chemotherapy for leptomeningeal metastasis in breast cancer: a randomized study. Eur J Cancer 40:2726–2733

    Article  PubMed  CAS  Google Scholar 

  14. Silvani A (2007) Experience with the intrathecal use of liposomal cytarabine at the Besta institute. Tumori 93(3):6–8 suppl

    PubMed  Google Scholar 

  15. Rueda Domínguez A, Olmos Hidalgo D, Viciana Garrido R, Torres Sánchez E (2005) Liposomal cytarabine (DepoCyte) for the treatment of neoplastic meningitis. Clin Transl Oncol 7(6):232–238

    Article  PubMed  Google Scholar 

  16. Esteva FJ, Soh LT, Holmes FA et al (2000) Phase II trial and pharmacokinetic evaluation of cytosine arabinoside for leptomeningeal metastases from breast cancer. Cancer Chemother Pharmacol 46:382–386

    Article  PubMed  CAS  Google Scholar 

  17. Partap S, Murphy PA, Vogel H et al (2011) Liposomal cytarabine for central nervous system embryonal tumors in children and young adults. J Neurooncol 103(3):561–566

    Article  PubMed  CAS  Google Scholar 

  18. Arita N, Taneda M, Hayakawa T (1994) Leptomeningeal dissemination of malignant glioma, incidence, diagnosis and outcome. Acta Neurochir (Wien) 126:84–92

    Article  CAS  Google Scholar 

  19. D’Haene N, Coen N, Neugroschl C et al (2009) Leptomeningeal dissemination of low grade intramedullary gliomas: about one case and review. Clin Neurol Neurosurg 111:390–394

    Article  PubMed  Google Scholar 

  20. Mazloom A, Hodges JC, The BS et al (2012) Outcome of patients with pilocytic astrocytoma and leptomeningeal dissemination. Int J Radiat Oncol Biol Phys 84(2):350–354

    Article  PubMed  Google Scholar 

  21. Nandipati S, Demopoulos A (2011) Leptomeningeal dissemination of anaplastic glioma: prolonged survival in two patients treated with temozolomide. J Neurooncol 105:663–665

    Article  PubMed  Google Scholar 

  22. Passarin MG, Moretto G, Musso AM et al (2010) Intrathecal liposomal cytarabine in combination with temozolomide in low grade oligoastrocytoma with leptomeningeal dissemination. J Neurooncol 97:439–444

    Article  PubMed  Google Scholar 

  23. Jaeckle KA (2006) Neoplastic meningitis from systemic malignancies: diagnosis, prognosis and treatment. Semin Oncol 33(3):312–323

    Article  PubMed  Google Scholar 

  24. Garcia-Marco JA, Panizo C, Garcia ES et al (2009) Efficacy and safety of liposomal cytarabine in lymphoma patients with central nervous system involvement from lymphoma. Cancer 115(9):1892–1898

    Article  PubMed  CAS  Google Scholar 

  25. Benesch M, Siegler N, Hoff K et al (2009) Safety and toxicity of intrathecal liposomal cytarabine (Depocyte) in children and adolescents with recurrent or refractory brain tumors: a multi-institutional retrospective study. Anticancer Drugs 20(9):794–799

    Article  PubMed  CAS  Google Scholar 

  26. Murry DJ, Blaney SM (2000) Clinical pharmacology of encapsulated sustained-release cytarabine. Ann Pharmacother 34(10):1173–1178

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neuro-Oncology Department, Fondazione IRCCS Istituto Neurologico C. Besta, Via Celoria 11, 20133, Milan, Italy

    P. Gaviani, A. Salmaggi, E. Lamperti, A. Botturi & A. Silvani

  2. Laboratory of Clinical Analyses, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy

    E. Corsini

  3. Neuroradiology Department, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy

    A. Erbetta

  4. Radiotherapy Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy

    I. Milanesi

  5. Neurosurgery Department, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy

    F. Legnani

  6. Neuropathology Department, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy

    B. Pollo

Authors
  1. P. Gaviani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Corsini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Salmaggi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. Lamperti
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Botturi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Erbetta
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. I. Milanesi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. F. Legnani
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. B. Pollo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. A. Silvani
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. Gaviani.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gaviani, P., Corsini, E., Salmaggi, A. et al. Liposomal cytarabine in neoplastic meningitis from primary brain tumors: a single institutional experience. Neurol Sci 34, 2151–2157 (2013). https://doi.org/10.1007/s10072-013-1358-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-013-1358-0

Keywords

Search

Navigation