Leveraging Molecular and Immune-Based Therapies in Leptomeningeal Metastases.

Autor: Wilcox JA; Department of Neurology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA., Boire AA; Department of Neurology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. boirea@mskcc.org.; Human Oncology and Pathogenesis Program, Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York, NY, USA. boirea@mskcc.org.
Jazyk: angličtina
Zdroj: CNS drugs [CNS Drugs] 2023 Jan; Vol. 37 (1), pp. 45-67. Date of Electronic Publication: 2022 Dec 06.
DOI: 10.1007/s40263-022-00975-5
Abstrakt: Leptomeningeal metastases represent an aggressive stage of cancer with few durable treatment options. Improved understanding of cancer biology, neoplastic reliance on oncogenic driver mutations, and complex immune system interactions have resulted in an explosion in cancer-directed therapy in the last two decades to include small molecule inhibitors and immune checkpoint inhibitors. Most of these therapeutics are underexplored in patients with leptomeningeal metastases, limiting extrapolation of extracranial and even intracranial efficacy outcomes to the unique leptomeningeal space. Further confounding our interpretation of drug activity in the leptomeninges is an incomplete understanding of drug penetration through the blood-cerebrospinal fluid barrier of the choroid plexus. Nevertheless, a number of retrospective studies and promising prospective trials provide evidence of leptomeningeal activity of several small molecule and immune checkpoint inhibitors and underscore potential areas of further therapeutic development for patients harboring leptomeningeal disease.
(© 2022. The Author(s).)
Databáze: MEDLINE
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