Combination intraventricular chemotherapy for meningeal neoplasia.

Giannone, Leonard; Greco, Filippo; Hainsworth, John D.

doi:10.1200/jco.1986.4.1.68

Cited by 113 publications

(48 citation statements)

References 20 publications

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“…However, it is noted that most series exclude patients that are too sick to receive any treatment, which may be up to one third of patients with NM [64]. Three agents are routinely used: methotrexate, cytarabine (including liposomal cytarabine or DepoCyt [Enzon Phar- [65][66][67]. Table 1 outlines the randomized clinical trials conducted for NM whereas Table 2 is an outline of the common treatment regimens for intra-CSF chemotherapy.…”

Section: Chemotherapymentioning

confidence: 99%

Neoplastic Meningitis

2008

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After completing this course, the reader should be able to:1. Describe the epidemiology of leptomeningeal metastasis.2. Participate in the diagnosis of leptomeningeal metastasis. Engage in the treatment of leptomeningeal metastasis.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTBackground: Neoplastic meningitis (NM) is a common problem in neuro-oncology, occurring in approximately 5% of all patients with cancer.Methods: Notwithstanding frequent focal signs and symptoms, NM is a disease affecting the entire neuraxis, and therefore staging and treatment need encompass all cerebrospinal fluid (CSF) compartments.Results: Central nervous system staging of NM includes contrast-enhanced cranial computerized tomography or magnetic resonance imaging (MR-Gd), contrast-enhanced spine magnetic resonance imaging or computerized tomographic myelography and radionuclide CSF flow study. Treatment of NM incorporates involved-field radiotherapy of bulky or

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Section: Chemotherapymentioning

confidence: 99%

Neoplastic Meningitis

2008

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“…However, only a few anticancer drugs, including methotrexate, cytosine arabinoside, triethylene thiophosphoramide, and 5-fluoro-2V -deoxyuridine (FdUrd), can be injected intrathecally (1)(2)(3)(4)(5). The intrathecal administration of these anticancer agents achieves a therapeutic efficacy of 40% to 70%, and leads to temporary cancer regression for a short period in some cases, but, in other many cases, fails to improve the patient's performance status.…”

Section: Introductionmentioning

confidence: 99%

Intrathecal Administration of Y-27632, a Specific Rho-Associated Kinase Inhibitor, for Rat Neoplastic Meningitis

Nakagawa¹,

Yoshioka

Miyahara³

et al. 2005

Molecular Cancer Research

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The small GTP-binding protein Rho and its target Rho-associated kinase trigger an intracellular signaling cascade that controls actin cytoskeleton and plays an essential role in cell motility and adhesion. A specific Rho-associated kinase inhibitor, Y-27632, has been reported to inhibit cancer invasion. Clinically, disseminated tumor cells in the cerebrospinal fluid invade the intraparenchymal region, damaging the brain and nerves, resulting in fatal brain stem dysfunction, despite intrathecal chemotherapy. To expand therapeutic options for this devastating neoplastic meningitis, we evaluated the potential use of intrathecal Y-27632 administration by employing Walker 256 cells, a rat mammary cancer cell line. Y-27632 dose-dependently inhibited chemotactic and invasive activity of Walker 256 cells. Y-27632 also inhibited the phosphorylation level of regulatory myosin light chain in vitro, but the effect was temporary and was considerably diminished within 16 hours. Y-27632 induced striking morphologic changes in Walker 256 cells, as evidenced by decreased cell-matrix adhesion in culture dishes and three-dimensional collagen I gels, and slightly inhibited colony formation in soft agar. Nevertheless, this drug treatment did not affect Walker 256 cell growth rate. We were able to administer continuous delivery of this inhibitor using an osmotic pump and maintaining drug concentration of 10 Mmol/L within the brain. Importantly, this concentration of Y-27632 showed minimal neurotoxicity both in vitro and in vivo. We found that an intrathecal therapy, combining 5-fluoro-2V -deoxyuridine with Y-27632, significantly increased the survival time of rats bearing meningeal carcinomatosis in comparison with animals treated with 5-fluoro-2V -deoxyuridine alone.Taken together, our findings indicate that continuous intrathecal administration of Y-27632 could be a promising therapeutic method when combined with chemotherapy for treating human neoplastic meningitis. (Mol Cancer Res 2005;3(8):425 -33)

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“…Another study evaluated 61 patients with LC (10 with lung cancer) and found a better median time to neurological progression for intrathecal liposomal cytarabine over intrathecal methotrexate (58 vs (82). However, other trials did not demonstrate superiority of intrathecal combination therapy over single-agent (83,84), therefore the role of a combination therapy remains uncertain. In addition to the most frequently used drugs, intrathecal administration of gemcitabine (85) or etoposide (86) has resulted in clinical activity in some case reports.…”

Section: Chemotherapy As Salvage Treatment For Progressive Bmsmentioning

confidence: 99%

State of the art of chemotherapy for the treatment of central nervous system metastases from non-small cell lung cancer

Inno¹,

Noia²,

D’Argento³

et al. 2016

Transl. Lung Cancer Res.

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Chemotherapy is the mainstay of treatment of advanced non-small cell lung cancer (NSCLC) without molecular drivers. Despite a low penetration of central nervous system (CNS), chemotherapy drugs demonstrated encouraging activity against CNS metastases from NSCLC. Based on the available data, chemotherapy should be considered as an important part of the multidisciplinary treatment of CNS metastases. Particularly, platinum-based regimens represent the most active combinations and pemetrexed is associated with a meaningful clinical benefit for patients with non-squamous histology. How to integrate chemotherapy and radiotherapy for newly diagnosed brain metastases (BMs) is still debated. Although flawed by some limitations, the available evidence suggests a role for upfront chemotherapy for the treatment of NSCLC patients with synchronous, asymptomatic BMs, thus allowing a delay of radiotherapy. Despite the introduction of modern and more effective chemotherapy, however, the prognosis of NSCLC patients with CNS metastases remains poor, especially for those with progressive BMs or leptomeningeal carcinomatosis (LC).

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Combination intraventricular chemotherapy for meningeal neoplasia.

Cited by 113 publications

References 20 publications

Neoplastic Meningitis

Neoplastic Meningitis

Intrathecal Administration of Y-27632, a Specific Rho-Associated Kinase Inhibitor, for Rat Neoplastic Meningitis

State of the art of chemotherapy for the treatment of central nervous system metastases from non-small cell lung cancer

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