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Neoplastic meningitis in solid tumors: from diagnosis to personalized treatments

Neoplastic meningitis (NM) is a devastating complication of solid tumors with poor outcome. Some randomized clinical trials have been conducted with heterogeneous inclusion criteria, diagnostic parameters, response evaluation and primary endpoints. Recently, the Leptomeningeal Assessment in Neuro-On...

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Autores principales: Pellerino, Alessia, Bertero, Luca, Rudà, Roberta, Soffietti, Riccardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5844521/
https://www.ncbi.nlm.nih.gov/pubmed/29535794
http://dx.doi.org/10.1177/1756286418759618
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author Pellerino, Alessia
Bertero, Luca
Rudà, Roberta
Soffietti, Riccardo
author_facet Pellerino, Alessia
Bertero, Luca
Rudà, Roberta
Soffietti, Riccardo
author_sort Pellerino, Alessia
collection PubMed
description Neoplastic meningitis (NM) is a devastating complication of solid tumors with poor outcome. Some randomized clinical trials have been conducted with heterogeneous inclusion criteria, diagnostic parameters, response evaluation and primary endpoints. Recently, the Leptomeningeal Assessment in Neuro-Oncology (LANO) Group and the European Society for Medical Oncology/European Association for Neuro-Oncology have proposed some recommendations in order to provide diagnostic criteria and response evaluation scores for NM. The aim of these guidelines is to integrate the neurological examination with magnetic resonance imaging and cerebrospinal fluid findings as well as to provide a framework for use in clinical trials. However, this composite assessment needs further validation. Since intrathecal therapy represents a treatment with limited efficacy in NM, many studies have been conducted on systemic therapies, including target therapies, with some encouraging results in terms of disease control. In this review, we have analyzed the clinical aspects and the most recent diagnostic tools and therapeutic options in NM.
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spelling pubmed-58445212018-03-13 Neoplastic meningitis in solid tumors: from diagnosis to personalized treatments Pellerino, Alessia Bertero, Luca Rudà, Roberta Soffietti, Riccardo Ther Adv Neurol Disord Review Neoplastic meningitis (NM) is a devastating complication of solid tumors with poor outcome. Some randomized clinical trials have been conducted with heterogeneous inclusion criteria, diagnostic parameters, response evaluation and primary endpoints. Recently, the Leptomeningeal Assessment in Neuro-Oncology (LANO) Group and the European Society for Medical Oncology/European Association for Neuro-Oncology have proposed some recommendations in order to provide diagnostic criteria and response evaluation scores for NM. The aim of these guidelines is to integrate the neurological examination with magnetic resonance imaging and cerebrospinal fluid findings as well as to provide a framework for use in clinical trials. However, this composite assessment needs further validation. Since intrathecal therapy represents a treatment with limited efficacy in NM, many studies have been conducted on systemic therapies, including target therapies, with some encouraging results in terms of disease control. In this review, we have analyzed the clinical aspects and the most recent diagnostic tools and therapeutic options in NM. SAGE Publications 2018-03-07 /pmc/articles/PMC5844521/ /pubmed/29535794 http://dx.doi.org/10.1177/1756286418759618 Text en © The Author(s), 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Pellerino, Alessia
Bertero, Luca
Rudà, Roberta
Soffietti, Riccardo
Neoplastic meningitis in solid tumors: from diagnosis to personalized treatments
title Neoplastic meningitis in solid tumors: from diagnosis to personalized treatments
title_full Neoplastic meningitis in solid tumors: from diagnosis to personalized treatments
title_fullStr Neoplastic meningitis in solid tumors: from diagnosis to personalized treatments
title_full_unstemmed Neoplastic meningitis in solid tumors: from diagnosis to personalized treatments
title_short Neoplastic meningitis in solid tumors: from diagnosis to personalized treatments
title_sort neoplastic meningitis in solid tumors: from diagnosis to personalized treatments
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5844521/
https://www.ncbi.nlm.nih.gov/pubmed/29535794
http://dx.doi.org/10.1177/1756286418759618
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