Leptomeningeal metastases from solid tumors: A Society for Neuro-Oncology and American Society of Clinical Oncology consensus review on clinical management and future directions

Author:

Wilcox Jessica A1ORCID,Chukwueke Ugonma N2ORCID,Ahn Myung-Ju3,Aizer Ayal A4ORCID,Bale Tejus A5ORCID,Brandsma Dieta6ORCID,Brastianos Priscilla K7ORCID,Chang Susan8ORCID,Daras Mariza9ORCID,Forsyth Peter10ORCID,Garzia Livia1112ORCID,Glantz Michael13ORCID,Oliva Isabella C Glitza14ORCID,Kumthekar Priya15ORCID,Le Rhun Emilie16ORCID,Nagpal Seema17ORCID,O’Brien Barbara18,Pentsova Elena1ORCID,Lee Eudocia Quant2ORCID,Remsik Jan1920ORCID,Rudà Roberta2122ORCID,Smalley Inna23ORCID,Taylor Michael D2425,Weller Michael26ORCID,Wefel Jeffrey18ORCID,Yang Jonathan T27ORCID,Young Robert J28,Wen Patrick Y2ORCID,Boire Adrienne A291ORCID

Affiliation:

1. Department of Neurology, Brain Tumor Service, Memorial Sloan Kettering Cancer Center , New York, New York , USA

2. Center for Neuro-Oncology, Dana-Farber Cancer Institute , Boston, Massachusetts , USA

3. Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea

4. Department of Radiation Oncology, Brigham and Women’s Hospital / Dana-Farber Cancer Institute, Harvard Medical School , Boston, Massachusetts , USA

5. Department of Pathology, Memorial Sloan Kettering Cancer Center , New York, New York , USA

6. Department of Neuro-Oncology, Netherlands Cancer Institute , Amsterdam , The Netherlands

7. Department of Neurology, Massachusetts General Hospital, Harvard Medical School , Boston, Massachusetts , USA

8. Division of Neuro-Oncology, Department of Neurosurgery, University of San Francisco California , San Francisco, California , USA

9. Department of Neurology, Virginia Commonwealth University , Richmond, Virginia , USA

10. Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute , Tampa, Florida , USA

11. Developmental and Stem Cell Biology Program, The Hospital for Sick Children , Toronto, Ontario , Canada

12. The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children , Toronto, Ontario , Canada

13. Department of Neurosurgery, Penn State College of Medicine , Hershey, Pennsylvania , USA

14. Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center , Houston, Texas , USA

15. The Lou and Jean Malnati Brain Tumor Institute, Robert H. Lurie Comprehensive Cancer Center of Northwestern University , Chicago, Illinois , USA

16. University Hospital and University of Zurich Departments of Neurology and Neurosurgery, Clinical Neuroscience Center, , Zurich , Switzerland

17. Division of Neuro-Oncology, Department of Neurology, Stanford University School of Medicine , Stanford, California , USA

18. Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center , Houston, Texas , USA

19. Laboratory for Immunology of Metastatic Ecosystems, Center for Cancer Biology , VIB, Leuven , Belgium

20. Department of Oncology, KU Leuven , Leuven , Belgium

21. Division of Neuro-Oncology, Department of Neuroscience, University and City of Health and Science Hospital , Turin , Italy

22. Department of Neurology, Castelfranco Veneto and Treviso Hospitals, Castelfranco Veneto , Italy

23. Department of Tumor Biology, The Moffitt Cancer Center and Research Institute , Tampa, Florida , USA

24. Texas Children’s Hospital Division of Neurosurgery, Department of Surgery, , Houston, Texas , USA   , Houston, Texas

25. Neuro-oncology Research Program, Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine Division of Neurosurgery, Department of Surgery, , Houston, Texas , USA   , Houston, Texas

26. Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich , Zurich , Switzerland

27. Department of Radiation Oncology, Department of Radiation Oncology, New York University School of Medicine , New York, New York , USA

28. Department of Radiology, Memorial Sloan Kettering Cancer Center , New York, New York , USA

29. Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center , New York, New York , USA

Abstract

Abstract Leptomeningeal metastases (LM) are increasingly becoming recognized as a treatable, yet generally incurable, complication of advanced cancer. As modern cancer therapeutics have prolonged the lives of patients with metastatic cancer, specifically in patients with parenchymal brain metastases, treatment options, and clinical research protocols for patients with LM from solid tumors have similarly evolved to improve survival within specific populations. Recent expansions in clinical investigation, early diagnosis, and drug development have given rise to new unanswered questions. These include leptomeningeal metastasis biology and preferred animal modeling, epidemiology in the modern cancer population, ensuring validation and accessibility of newer leptomeningeal metastasis diagnostics, best clinical practices with multimodality treatment options, clinical trial design and standardization of response assessments, and avenues worthy of further research. An international group of multi-disciplinary experts in the research and management of LM, supported by the Society for Neuro-Oncology and American Society of Clinical Oncology, were assembled to reach a consensus opinion on these pressing topics and provide a roadmap for future directions. Our hope is that these recommendations will accelerate collaboration and progress in the field of LM and serve as a platform for further discussion and patient advocacy.

Funder

NIH/NCI Cancer Center

Publisher

Oxford University Press (OUP)

Reference185 articles.

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