title: Safety and Efficacy of Liposomal Cytarabine in the Treatment of Neoplastic Meningitis.
abstract: OBJECTIVE
  Although rare, neoplastic meningitis (NM) has been increasingly observed in patients with cancer due to the prolonged course of the disease. Intrathecal chemotherapy with methotrexate or cytarabine with repeating injection schedules of 2-3 times per week is currently the mainstay of treatment. An efficacious and comfortable treatment alternative might be represented by liposomal cytarabine.
  
  
  METHODS
  In this retrospective study, we reviewed all patients with NM due to solid tumors or hematological malignancies treated with liposomal cytarabine at our institution between March 2004 and September 2011. The primary endpoint was treatment response, which was defined as improvement in neurological symptoms and/or conversion of the initial cerebrospinal fluid cytology and/or response in the radiological findings. The main secondary endpoint was safety.
  
  
  RESULTS
  Fifty-one adult patients were evaluable for safety and 44 patients for efficacy. In 36 patients (81.8%), a treatment response was achieved. The median overall survival after diagnosis of NM was 11 months (95% confidence interval 8.8-13.2). Adverse events grade 1-4 occurred in 31 patients (60.8%), whereas grade 3-4 occurred in 18 patients (35.3%).
  
  
  CONCLUSIONS
  The encouraging efficacy and safety data obtained in our analysis and the convenient administration schedule make intrathecal liposomal cytarabine a favorable treatment option for NM patients.
authors: Department of Hematology/Oncology, Martin-Luther University Halle-Wittenberg, Halle, Germany.
authors: Franziska
authors: F
authors: Jahn
authors: Karin
authors: K
authors: Jordan
authors: Timo
authors: T
authors: Behlendorf
authors: Cordula
authors: C
authors: Globig
authors: Hans-Joachim
authors: HJ
authors: Schmoll
authors: Carsten
authors: C
authors: Müller-Tidow
authors: Berit
authors: B
authors: Jordan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D003561:Cytarabine / Q000008:administration & dosage* / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007278:Injections, Spinal / Q000009:adverse effects; D053208:Kaplan-Meier Estimate; D008081:Liposomes; D008297:Male; D008581:Meningitis / Q000188:drug therapy* / Q000209:etiology*; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D008081:Liposomes; D003561:Cytarabine