Leptomeningeal metastases in non-small-cell lung cancer

Leptomeningeal metastasis is a complication of advanced non-small-cell lung cancer (NSCLC). Diagnosis and monitoring of leptomeningeal metastasis are challenging, and are based on neurological, radiographic, and cerebrospinal fluid findings. Substantial progress has been made in several key aspects...

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Bibliographic Details
Published in:The lancet oncology 2018-01, Vol.19 (1), p.e43-e55
Main Authors: Cheng, Haiying, Perez-Soler, Roman
Format: Article
Language:English
Subjects:
Animal models
Biopsy
Blood-brain barrier
Breast cancer
Cancer therapies
Cell cycle
Central nervous system
Cerebrospinal fluid
Chemotherapy
Cytology
Deoxyribonucleic acid
DNA
Drug dosages
Genotyping
Glycoproteins
Hydrogen bonds
Lung cancer
Lymphoma
Medical prognosis
Meninges
Metastases
Metastasis
Mutation
Non-small cell lung carcinoma
Patients
Permeability
Plasma
Radiation therapy
Small cell lung carcinoma
Tumors
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Summary:Leptomeningeal metastasis is a complication of advanced non-small-cell lung cancer (NSCLC). Diagnosis and monitoring of leptomeningeal metastasis are challenging, and are based on neurological, radiographic, and cerebrospinal fluid findings. Substantial progress has been made in several key aspects of management of leptomeningeal metastasis, including improved characterisation of the genetic profiles, generation of clinically relevant animal models, advances in cerebrospinal fluid liquid biopsy with improved cytology and genotyping analysis, and the development of therapeutic agents with greater CNS penetration. This Review discusses cumulative data on multiple treatment modalities with a particular focus on recent advances in molecularly targeted therapies in subtypes of patients with leptomeningeal metastasis from NSCLC. Future research is needed to further understand the biology of leptomeningeal metastasis and the mechanisms of resistance to treatment.
ISSN:1470-2045
1474-5488
DOI:10.1016/S1470-2045(17)30689-7