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Management of leptomeningeal metastasis in patients with lung cancer


Leptomeningeal metastasis (LM) is a rare complication of lung cancer. It occurs in approximately 1–6% of patients with lung cancer and it is most commonly associated with adenocarcinoma (50–56%), followed by squamous cell carcinoma (26–36%) and small cell carcinoma (13–14%) [1]. Lung cancer patients harboring activating mutations in EGFR are associated with prolonged disease control and survival when tyrosine kinase inhibitors (TKIs), such as erlotinib and gefitinib are used. These improvements may contribute to a relative increase in the prevalence of LM from non-small-cell lung cancer (NSCLC), which is still a devastating complication associated with poor survival. Even with maximal therapy, average survival following the diagnosis of LM is less than 1 year [2]. The optimal therapeutic approach for LM remains challenging. Poor penetration of chemotherapeutic agents beyond the blood–brain barrier (BBB) is in part responsible for the limited therapeutic options for LM patients.

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