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Meningeal disease (LMD), also known as meningeal carcinoma or cancerous meningitis, is a phenomenon characterized by the metastatic spread of cancer cells to the meninges
.
According to reports, LMD occurs in up to 10% of solid tumors and 5-15% of hematological malignancies
The histology of primary solid tumors most often associated with the development of LMD includes those from the breast, lung, and skin (melanoma)
.
Although LMD often occurs at the same time as a substantial disease, it can also occur without substantial brain metastases
LMD poor prognosis of patients occurred with an average of 3-7 weeks with poor prognosis patients LMD occurs, on average 3-7 weeks
Although there are many treatments for LMD patients, there are big differences in practice due to the lack of prospective clinical trial data
.
Multimodal treatment is usually to relieve symptoms and optimize quality of life, not to prolong survival
In clinical trials, systemic therapy and intrathecal therapy (IT) have mixed results in terms of survival benefits, which may be caused by a variety of factors, such as the biological heterogeneity of the primary tumor, and the bias in clinical trial recruitment For more suitable patients, and the number of recruits is small
.
At present, the side effects of these traditional treatments are still a major problem , which can include leukemia, subacute encephalopathy, acute cerebellar syndrome, aseptic meningitis (up to 43% of patients) and infectious meningitis (receiving IT treatment) 8-24% of patients)
.
Patients with LMD urgently need treatments that can provide meaningful survival benefits and acceptable toxicity
The side effects of these traditional treatments are still a major problem infection
Recently, researchers proposed a single-arm phase II study in which 18 patients with LMD received a combination of ipilimumab and nivolumumab until the disease progressed or unacceptable toxicity (NCT02939300)
.
The primary endpoint of the trial is 3 months of overall survival (OS3)
18 patients with LMD received the combination therapy of ipilimumab and nivolumumab until the disease progressed or unacceptable toxicity (NCT02939300) 18 patients with LMD received ipilimumab and nivolumumab Combination therapy of serotonin until the disease progresses or unacceptable toxicity (NCT02939300)
The overall survival rate of 18 patients with solid tumor LMD
.
.
The overall survival rate of 18 patients with solid tumor LMD
The study met its primary endpoint because 18 patients had 8 (OS3 is 0.
Therefore, this study shows that the combined use of ipilimumab and nivolumumab has acceptable safety and shows promising activity in LMD patients
.
This result needs to be verified by a larger multi-center clinical trial
The combined use of ipilimumab and nivolumumab has acceptable safety
Original source:
Original source:Priscilla K.
Priscilla K.
Brastianos al.
Phase II study of ipilimumab and nivolumab in leptomeningeal carcinomatosis.
Phase II study of ipilimumab and nivolumab in leptomeningeal carcinomatosis.
Nature Communications (2 021).
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