Meningeosis carcinomatosa beim Mammakarzinom

Abstract

Breast cancer is the solid tumour with the highest incidence rate of meningitis carcinomatosa. The HER2-positive and triple-negative phenotypes are possible high risk constellations for the development of CNS metastases in these subgroups. It is expected that improved efficacy of new treatment options will lead to a further increase of CNS metastases in breast cancer patients, especially in case of tumours with HER2-overexpression and pre-treatment with the monoclonal antibody trastuzumab. Based on the total population, the prognosis of meningitis carcinomatosa is generally unfavourable. However, occasional reports of long-term survivors continue to arise, especially among breast cancer patients. The development of new cytostatic drugs aims to improve the current standard treatment, which includes intrathecal chemotherapy with cytostatics. Liposomal cytarabine is characterized by a more favourable pharmacokinetic profile in comparison with the former reference substance methotrexate, allowing significantly prolonged application intervals. In the light of current clinical data, it is reasonable to assume that this drug has increased significance in patients with meningeal metastatatized breast cancer. Especially subgroups with additional favourable criterions, which require further definition in future studies, may profit from the intrathecal treatment with liposomal cytarabine.