Leptomeningeal Metastases in Melanoma Patients: An Update on and Future Perspectives for Diagnosis and Treatment.
Julian SteiningerFrank Friedrich GellrichKay EngellandtMatthias MeinhardtDana WestphalStefan BeissertFriedegund MeierIsabella C Glitza OlivaPublished in: International journal of molecular sciences (2023)
Leptomeningeal disease (LMD) is a devastating complication of cancer with a particularly poor prognosis. Among solid tumours, malignant melanoma (MM) has one of the highest rates of metastasis to the leptomeninges, with approximately 10-15% of patients with advanced disease developing LMD. Tumour cells that metastasise to the brain have unique properties that allow them to cross the blood-brain barrier, evade the immune system, and survive in the brain microenvironment. Metastatic colonisation is achieved through dynamic communication between metastatic cells and the tumour microenvironment, resulting in a tumour-permissive milieu. Despite advances in treatment options, the incidence of LMD appears to be increasing and current treatment modalities have a limited impact on survival. This review provides an overview of the biology of LMD, diagnosis and current treatment approaches for MM patients with LMD, and an overview of ongoing clinical trials. Despite the still limited efficacy of current therapies, there is hope that emerging treatments will improve the outcomes for patients with LMD.
Keyphrases
- poor prognosis
- induced apoptosis
- clinical trial
- squamous cell carcinoma
- small cell lung cancer
- stem cells
- cell cycle arrest
- long non coding rna
- newly diagnosed
- white matter
- ejection fraction
- endoplasmic reticulum stress
- multiple sclerosis
- type diabetes
- prognostic factors
- combination therapy
- cell proliferation
- patient reported outcomes
- metabolic syndrome
- blood brain barrier
- cerebral ischemia
- skeletal muscle
- subarachnoid hemorrhage
- glycemic control
- phase iii
- study protocol
- double blind