Photo Credit: DouglasOlivares

The following is a summary of “A Comprehensive Review of Current Treatment Modalities for Leptomeningeal Carcinomatosis in Breast Cancer,” published in the September 2024 issue of Oncology by Morris et al.

Leptomeningeal carcinomatosis (LC), a rare but severe metastatic complication of breast cancer, presents a significant clinical challenge due to its poor prognosis and debilitating neurological symptoms. As cancer survival rates improve, the incidence of LC has risen, yet an established treatment protocol remains elusive, with limited clinical trial data comparing available therapeutic options. 

This comprehensive review conducted a thorough literature search of PubMed and Cochrane databases to evaluate current treatment modalities for LC in breast cancer patients, focusing on their safety and efficacy profiles. Traditional treatment approaches, including intrathecal chemotherapy, systemic chemotherapy, and radiotherapy, are discussed, highlighting their benefits and limitations in managing LC. 

However, with no definitive standard of care, the role of emerging therapies offers new hope. Targeted therapies, CAR-T cell therapy, immune checkpoint inhibitors, CDK inhibitors, and novel antibody-drug conjugates are evaluated for their potential to improve outcomes for LC patients. Despite promising preclinical and early clinical data, further studies are necessary to establish their efficacy in LC management fully. A proposed treatment pathway is also outlined to provide clinicians with a practical guide for the multidisciplinary management of this complex metastatic condition. This framework addresses the therapeutic landscape and the integration of novel agents, balancing efficacy with patient quality of life. As LC remains a significant challenge in metastatic breast cancer, the advancement of personalized, targeted treatments could offer improved prognosis and neurological symptom management in this patient population. Future clinical trials should prioritize evaluating these emerging therapies and their potential to transform the treatment paradigm for LC in breast cancer.

Source: sciencedirect.com/science/article/abs/pii/S1040842824002567