Cerebrospinal fluid-administered therapies for leptomeningeal metastases from solid tumors.
Archit B BaskaranAnkush BhatiaPriya U KumthekarAdrienne A BoireRimas V LukasPublished in: Future oncology (London, England) (2023)
Aims/purpose: Leptomeningeal metastases (LM) are associated with substantial morbidity and mortality. Several approaches are used to treat LM, including intrathecally administered therapies. We consolidated current studies exploring intrathecal therapies for LM treatment. Patients & methods: A review of clinical trials using intrathecal agents was conducted with outcomes tabulated and trends described. 48 trials met the inclusion criteria. Initial investigations began with cytotoxic agents; following this were formulations with longer cerebrospinal fluid half-lives, targeted antibodies and radionucleotides. Results & conclusion: Outcomes were not reported consistently. Survival, when reported, remained poor. Intrathecal therapies for LM remain a viable option. Their use can be informed by an understanding of efficacy, safety and toxicity. They may be an important component of future LM treatments.
Keyphrases
- cerebrospinal fluid
- clinical trial
- end stage renal disease
- ejection fraction
- newly diagnosed
- prognostic factors
- oxidative stress
- type diabetes
- small cell lung cancer
- peritoneal dialysis
- metabolic syndrome
- tyrosine kinase
- adipose tissue
- replacement therapy
- study protocol
- weight loss
- brain metastases
- case control
- oxide nanoparticles