Treatment of leptomeningeal carcinomatosis from breast cancer with systemically administered chemotherapy

Abstract

764 Background: Leptomeningeal carcinomatosis is a rare complication of breast cancer. Standard treatment includes intrathecal methotrexate and radiation. The results of therapy are unsatisfactory and the prognosis is poor. Methods: We report two patients with breast cancer and meningeal involvement who responded to systemic chemotherapy with carboplatinum (AUC6) and docetaxel (75mg/M2. This regimen was chosen because of the preclinical synergy of these agents, proven efficacy in metastatic breast cancer, and the ability of carboplatinum to treat brain tumors. Results: Patient #1 developed isolated leptomeningeal disease 18 months after responding to neoadjuvant therapy with cyclophosphamide and doxorubicin for locally advanced breast cancer. She was originally treated with intrathecal methotrexate without response, followed by craniospinal irradiation with clinical stabilization. Eighteen months after radiation she again developed symptomatic meningeal disease along with early metastases in lung and live...