Department of Medical Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA.
Kolkata Medical College and Hospital, India.
Expert Rev Neurother. 2024 Jan-Jun;24(1):77-103. doi: 10.1080/14737175.2023.2293223. Epub 2024 Jan 8.
Neoplastic meningitis (NM), also known as leptomeningeal carcinomatosis, is characterized by the infiltration of tumor cells into the meninges, and poses a significant therapeutic challenge owing to its aggressive nature and limited treatment options. Breast cancer is a common cause of NM among solid tumors, further highlighting the urgent need to explore effective therapeutic strategies. This review aims to provide insights into the evolving landscape of NM therapy in breast cancer by collating existing research, evaluating current treatments, and identifying potential emerging therapeutic options.
This review explores the clinical features, therapeutic strategies, recent advances, and challenges of managing NM in patients with breast cancer. Its management includes multimodal strategies, including systemic and intrathecal chemotherapy, radiation therapy, and supportive care. This review also emphasizes targeted drug options and optimal drug concentrations, and discusses emerging therapies. Additionally, it highlights the variability in treatment outcomes and the potential of combination regimens to effectively manage NM in breast cancer.
Challenges in treating NM include debates over clinical trial end points and the management of adverse effects. Drug resistance and low response rates are significant hurdles, particularly inHER2-negative breast cancer. The development of more precise and cost-effective medications with improved selectivity is crucial. Additionally, global efforts are needed for infrastructure development and cancer control considering the diverse nature of the disease.
癌性脑膜炎（NM），又称脑膜癌病，其特征是肿瘤细胞浸润脑膜，由于其侵袭性和有限的治疗选择，这给治疗带来了巨大的挑战。乳腺癌是实体瘤中 NM 的常见病因，这进一步凸显了探索有效治疗策略的迫切需要。通过汇集现有研究、评估现有治疗方法并确定潜在的新兴治疗选择，本综述旨在深入了解乳腺癌中 NM 治疗的最新进展。
本综述探讨了乳腺癌患者 NM 的临床特征、治疗策略、最新进展和管理挑战。NM 的管理包括包括多模式策略，包括全身和鞘内化疗、放射治疗和支持性护理。本综述还强调了靶向药物选择和最佳药物浓度，并讨论了新兴疗法。此外，还强调了治疗结果的可变性以及联合方案在有效管理乳腺癌 NM 方面的潜力。
治疗 NM 的挑战包括临床试验终点和不良反应管理的争议。药物耐药性和低反应率是一个重大障碍，特别是在 HER2 阴性乳腺癌中。开发更精确和更具成本效益的、具有更高选择性的药物至关重要。此外，考虑到该疾病的多样性，需要全球努力来发展基础设施和癌症控制。
