Novel Therapeutic Approaches in Neoplastic Meningitis

SIMPLE SUMMARY: Neoplastic meningitis (NM) is a frequent complication of cancer and is associated with a poor prognosis. The currently available therapies aim to alleviate symptoms and preserve the quality of life. It comprises a multimodal approach, including surgery, intrathecal and systemic chemotherapy, and radiotherapy. The specific treatment is individualized, based on clinical practice guidelines and expert opinion. There are multiple clinical trials undertaken to evaluate the efficacy of novel therapies, including targeted and immunotherapies. This article presents an updated review of treatment approaches in NM. ABSTRACT: Central nervous system (CNS) metastasis from systemic cancers can involve the brain parenchyma, leptomeninges, or the dura. Neoplastic meningitis (NM), also known by different terms, including leptomeningeal carcinomatosis and carcinomatous meningitis, occurs due to solid tumors and hematologic malignancies and is associated with a poor prognosis. The current management paradigm entails a multimodal approach focused on palliation with surgery, radiation, and chemotherapy, which may be administered systemically or directly into the cerebrospinal fluid (CSF). This review focuses on novel therapeutic approaches, including targeted and immunotherapeutic agents under investigation, that have shown promise in NM arising from solid tumors.