Thérapies dans la méningite carcinomateuse du cancer du poumon, du sein et le mélanome : revue systématique de la littérature

Abstract

Introduction: Carcinomatous meningitis is a rare complication that occurs most often in patients with lung cancer, breast cancer, or melanoma, generally with poor prognosis. Management poses a therapeutic challenge, particularly due to the partial permeability of the blood-brain barrier to various cancer treatments. Our objective was to conduct a systematic review of therapies proposed for carcinomatous meningitis in the context of these three primary tumors, using the 2017 guidelines from the European Society for Medical Oncology (ESMO) as our initial foundation.Method: We conducted a systematic literature review on PubMed and ClinicalTrial between 2017 and August 2023, which allowed us to identify 116 articles for this review, including 19 prospective trials.Results: The primary findings from therapeutic studies conducted between 2017 and 2023 have been summarized in concise tables categorized by the primary tumor.Discussion: Carcinomatous meningitis remains an incurable condition with a grim prognosis. The therapeutic approaches currently employed, outside of clinical trials, have demonstrated modest efficacy, particularly with regard to intravenous and intrathecal chemotherapy. Nevertheless, there are promising avenues, including targeted therapies, conjugated antibodies, immunotherapy, and proton therapy. Multiple studies are currently underway, with a significant emphasis on including patients with carcinomatous meningitis.