Leptomeningeal Carcinomatosis: Molecular Landscape, Current Management, and Emerging Therapies.
Leptomeningeal Carcinomatosis: Molecular Landscape, Current Management, and Emerging Therapies.
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DOI：
10.1016/j.nec.2020.06.010
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发表时间：
2020-10
影响因子：
2.6
通讯作者：
Hayden Gephart M
中科院分区：
文献类型：
--
作者：
Bhambhvani HP;Rodrigues AJ;Umeh-Garcia MC;Hayden Gephart M
软脑膜癌病（LMC），也称为软脑膜转移或软脑膜疾病，是癌症转移扩散到软脑膜，蛛网膜和蛛网膜下腔。1 LMC发生在5%至15%的癌症患者中，治疗选择有限，平均生存时间为2至6个月。1-6 LMC最常由起源于中枢神经系统（CNS）外的原发性癌症转移引起，但LMC也可由原发性CNS肿瘤引起，包括星形细胞瘤、髓母细胞瘤和室管膜瘤。LMC的发病率在原发性肿瘤类型中持续稳步增加，这可能是因为更灵敏的检测方法和能够控制全身性疾病的治疗方法的疗效提高。1，8目前，全脑或颅-脊髓放疗和鞘内（IT）或全身化疗提供了有限的生存获益，但存在治疗相关毒性的重大风险。5，9因此，对疾病发病机制进行更全面的表征以确定新的治疗靶点的需求变得越来越紧迫。虽然最近的科学进步已经增加了对恶性细胞如何在软脑膜内播种和茁壮成长的理解，但仍然需要更多的研究。在这篇综述中，作者总结了他们目前对LMC的分子景观的理解，概述了这些患者的临床管理，并强调了新兴的治疗选择。
Leptomeningeal carcinomatosis (LMC), also known as leptomeningeal metastasis or leptomeningeal disease, is the metastatic spread of cancer to the pia mater, arachnoid, and subarachnoid space. 1 LMC occurs in 5% to 15% of patients with cancer, has limited therapeutic options, and has an average survival time of 2 to 6 months. 1–6 LMC most commonly arises as a result of metastasis from primary cancers originating outside the central nervous system (CNS), but LMC can also arise from primary CNS tumors, including astrocytomas, medulloblastomas, and ependy-momas. 7 The incidence of LMC continues to steadily increase across primary tumor types, likely because of more sensitive detection methods and improved efficacy of therapeutics able to control systemic disease. 1, 8 Currently, whole brain or cranial-spinal radiation and intrathecal (IT) or systemic chemotherapy have offered limited survival benefit with substantial risks of treatment-related toxicity. 5, 9 Thus, the need for a more comprehensive characterization of disease pathogenesis in order to identify novel therapeutic targets has become increasingly urgent. Although recent scientific advances have increased the understanding of how malignant cells seed and thrive within the leptomeninges, more studies are still required. In this review, the authors summarize their current understanding of the molecular landscape of LMC, outline clinical management of these patients, and highlight emerging therapeutic options.
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DOI：
10.1016/s1470-2045(14)70364-x
发表时间：
2014-12
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Brewster AM;Chavez-MacGregor M;Brown P
通讯作者：
Brown P
影响因子：
9.9
作者：
CHAMBERLAIN, MC;SANDY, AD;PRESS, GA
通讯作者：
PRESS, GA
影响因子：
4.1
作者：
Chamberlain, MC;Kormanik, PA;Barba, D
通讯作者：
Barba, D
影响因子：
2.7
作者：
Chamberlain, Marc C.
通讯作者：
Chamberlain, Marc C.
影响因子：
3.2
作者：
Ballester, Leomar Y.;Oliva, Isabella C. Glitza;Davies, Michael A.
通讯作者：
Davies, Michael A.