title: A retrospective case series of 103 consecutive patients with leptomeningeal metastasis and breast cancer.
abstract: Approximately 2-5 % of patients with breast cancer (BC) develop leptomeningeal metastasis (LM). 103 consecutive patients with BC were diagnosed with LM and initially treated with intra-CSF liposomal cytarabine from 2007 to 2011 at a single institution. Correlations were determined with respect to patient characteristics and BC subtype with regard to overall survival (OS). At LM diagnosis, 61 % of patients had a 0-2 performance status (PS), the remaining 39 % were severely neurologically impaired. Regardless of PS, all patients received intra-cerebrospinal fluid (CSF) liposomal cytarabine as first-line treatment. Systemic treatment and radiotherapy were also given in 58 and 17 % of patients respectively as clinically appropriate. Second- (intra-CSF thiotepa) and third-line (intra-CSF methotrexate) treatment was administered in 24 and 6 patients respectively. Median OS was 3.8 months (range 1 day-2.8 years). In multivariate analysis, an initial combined treatment, a second-line treatment with intra-CSF thiotepa, an initial clinical response, and a non-'ER/PR/HER2 negative' BC were significantly associated with a better OS. Median OS in this heterogeneous retrospective case series was similar to that of previously observed BC patients treated with intra-CSF methotrexate suggesting intra-CSF liposomal cytarabine is a reasonable first choice therapy of BC-related LM.
authors: Department of Medical Oncology, Oscar Lambret Center, 3 rue Frédéric Combemale, 59020 Lille Cedex, France. emilie.lerhun@chru-lille.fr
authors: E
authors: E
authors: Le Rhun
authors: S
authors: S
authors: Taillibert
authors: F
authors: F
authors: Zairi
authors: N
authors: N
authors: Kotecki
authors: P
authors: P
authors: Devos
authors: A
authors: A
authors: Mailliez
authors: V
authors: V
authors: Servent
authors: L
authors: L
authors: Vanlemmens
authors: P
authors: P
authors: Vennin
authors: T
authors: T
authors: Boulanger
authors: M C
authors: MC
authors: Baranzelli
authors: C
authors: C
authors: André
authors: G
authors: G
authors: Marliot
authors: J L
authors: JL
authors: Cazin
authors: F
authors: F
authors: Dubois
authors: R
authors: R
authors: Assaker
authors: J
authors: J
authors: Bonneterre
authors: M C
authors: MC
authors: Chamberlain
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D003561:Cytarabine / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D053208:Kaplan-Meier Estimate; D008081:Liposomes; D055756:Meningeal Carcinomatosis / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D008081:Liposomes; D003561:Cytarabine