Division of Medical Oncology, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
Division of Medical Oncology, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
Lancet Oncol. 2018 Jan;19(1):e43-e55. doi: 10.1016/S1470-2045(17)30689-7.
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.
脑膜转移是晚期非小细胞肺癌（NSCLC）的一种并发症。脑膜转移的诊断和监测具有挑战性，基于神经学、影像学和脑脊液发现。脑膜转移的管理在多个关键方面取得了重大进展，包括对遗传特征的更好描述、生成更具临床相关性的动物模型、脑脊液液体活检的进步，包括细胞遗传学和基因分型分析的改进，以及具有更大中枢神经系统穿透性的治疗药物的开发。本综述讨论了多种治疗方式的累积数据，特别关注 NSCLC 脑膜转移患者亚组中分子靶向治疗的最新进展。需要进一步的研究来深入了解脑膜转移的生物学和对治疗的耐药机制。
