Cisplatin and temozolomide combination in the treatment of leptomeningeal carcinomatosis from ethmoid sinus intestinal-type adenocarcinoma

Abstract

Intestinal-type adenocarcinoma of the nasal cavities and paranasal sinuses is a relatively rare tumor. Standard therapeutic modalities include surgery followed by radiotherapy, sometimes with chemotherapy treatment. Despite these treatments, the outcome is poor due to frequent local recurrences constituting the main cause of death among patients; leptomeningeal carcinomatosis is not a frequent event, and its presence indicates short expected survival. The therapy of neoplastic meningitis includes cranial irradiation, intrathecal chemotherapy and high-dose systemic chemotherapy. However, these approaches report important side effects with only modest efficacy. Thus, it is important to discover better treatment for this cancer complication. We present, for the first time, a case of leptomeningeal carcinomatosis from invasive intestinal-type adenocarcinoma treated with temozolomide and cisplatin chemotherapy obtaining a prolonged reduction and stabilization of the lesion improving the clinical condition of the patient.

Leptomeningeal carcinomatosis from gastric cancer successfully treated by the intrathecal methotrexate plus temozolomide and simultaneous radiotherapy: Case report and literatures review

“…In addition, published case report studies have proven the efficiency of Temozolomide. 25,26 Therefore, oral temozolomide was well-tolerated in this patient.…”

Cisplatin and Temozolomide Combination in the Treatment of Supratentorial Anaplastic Ependymoma

“…These preclinical and clinical studies suggest that cisplatin may enhance the antitumor activity of temozolomide. There are two other factors also contributing to the rationale for the combination of temozolomide and cisplatin: both showed activity against ependymoma [1,5,14] and other brain tumors; in prior studies, this combination was found to have been well tolerated [7,8,23,24]. …”

“…The rationale for this regimen was that cisplatin might enhance the antitumor activity of temozolomide with a favorable safety profile [7,8]. …”

Phase II trial of temozolomide plus concurrent whole-brain radiation followed by TNV regimen as adjuvant therapy for patients with newly diagnosed primary CNS lymphoma

“…[12] Platinum drugs can inhibit MGMT transcription and downregulate the expression of MGMT. [13] This is the basis for the synergistic effect of temozolomide and platinum drugs. So, nedaplatin was added to our chemotherapy in an attempt to improve upon therapeutic efficacy.…”