ArticleJournal of neuro-oncology2022
Intrathecal therapy for the management of leptomeningeal metastatic disease: a scoping review of the current literature and ongoing clinical trials.
Article in Journal of neuro-oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 22 citations in OpenAlex.
- Melanoma leptomeningeal disease: Advances in diagnosis and emerging therapeutic strategies.World journal of experimental medicine · 2026Review
- Preclinical models of melanoma leptomeningeal disease to assess intrathecal checkpoint blockade.Scientific reports · 2025Article
- Leptomeningeal metastasis in triple-negative breast cancer: a retrospective study.Discover oncology · 2025Article
- Chinese Expert Consensus on Leptomeningeal Metastases of Lung Cancer.Thoracic cancer · 2025Article
- Comparative analysis of the lumboperitoneal shunt versus ventriculoperitoneal shunt for leptomeningeal metastasis-associated hydrocephalus in non-small cell lung cancer.Acta neurochirurgica · 2025Article
- Cerebral spinal fluid analyses and therapeutic implications for leptomeningeal metastatic disease.Journal of neuro-oncology · 2025Review
- Leptomeningeal metastatic disease: new frontiers and future directions.Nature reviews. Clinical oncology · 2025Review
- Application and Safety of Externally Controlled Metronomic Drug Delivery to the Brain by an Implantable Smart Pump in a Sheep Model.Neurosurgery · 2025Article
- Case Report: Extended survival in KRAS-G12V NSCLC with leptomeningeal metastasis through integrated intrathecal chemotherapy and systemic therapies.Frontiers in pharmacology · 2025Article
- Intrathecal topotecan with systemic checkpoint inhibitor therapy for gastroesophageal cancer with leptomeningeal involvement: two case reports and review of the literature.Journal of gastrointestinal oncology · 2024Article
- Case report: Concurrent intrathecal and intravenous pembrolizumab for metastatic melanoma with leptomeningeal disease.Frontiers in oncology · 2024Article
- Building Team Medicine in the Management of CNS Metastases.Journal of clinical medicine · 2023Article
- Role of Systemic Immunoinflammation Landscape in the Overall Survival of Patients with Leptomeningeal Metastases from Lung Cancer.OncoTargets and therapy · 2023Article
- Comparison of intracerebrospinal fluid methotrexate by Ommaya reservoir versus lumbar puncture in leptomeningeal carcinomatosis with hydrocephalus: a retrospective cohort study.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeLeptomeningeal metastatic disease (LMD) from advanced malignancies has poor prognoses and limited treatments. Intrathecal therapy (ITT) protocols are available, showing variable outcomes. We reviewed the therapeutic and toxicity profiles of ITT in LMD.
methodsPubMed, EMBASE, Web-of-Science, and Scopus were searched following the PRISMA-ScR guidelines to include studies reporting ITT for LMD. CLINICALTRIAL: gov and Cochrane were searched to identify ongoing clinical trials.
resultsWe included 27 published studies encompassing 2161 patients and 4 ongoing trials. LMD originated from brain metastases (85.5%), lymphomas (5.4%), high-grade gliomas (4.6%), medulloblastomas (2.3%), and leukemias (2.1%). LMD was mostly diagnosed with the co-presence of neurological-related symptoms and positive imaging and/or cerebrospinal fluid cytology (60.8%). The most common ITT agents were methotrexate (35.9%), cytarabine (21.9%), and thiotepa (8.2%), standalone or combined. Patients received a median of 6.5 ITT cycles (range, 1.0-71.0) via intraventricular (58.8%) or lumbar intrathecal (41.2%) routes. The Ommaya reservoir was implanted in 38.5% cases. Concurrent systemic chemotherapy (45.2%) and/or radiotherapy (30.6%) were used. After 1-3 cycles, 44.7% patients had improved clinical status and 29.9% converted into negative cerebrospinal fluid cytology. The most common ITT-related severe adverse events were neutropenia (6.5%), meningitis (5.2%) and encephalopathy (4.5%). Median freedom from progression was 2.4 months (range, 0.1-59.5) and median overall survival 5.5 months (range, 0.1-148.0).
conclusionCurrent ITT protocols are variable but effective and well-tolerated in LMD. Ongoing trials are investigating dose-limiting toxicity profiles and long-term overall survival. Future studies should analyze the therapeutic and safety profiles of ITT compared to newer systemic therapies.
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