Clinical characteristics and outcomes in leptomeningeal disease with or without brain metastasis: insights from an explorative data analysis of the Charité LMD registry

• DOI: 10.1007/s11060-025-04937-x
• Publication Date: 2025-02-11T14:32:25Z
• Authors: David Wasilewski; Chiara Eitner; Rober Ates; Selin Murad; Zoe Shaked; Julia Alexandra S...; Andreas Wetzel-Ya...; Tarik Alp Sargut; Judith Rösler; Majd Abdulhamid S...; Peter Truckenmüller; Robert Mertens; Daniel Kroneberg; Alexander Kowski; Helena Radbruch; David Capper; Felix Ehret; Siyer Roohani; Nikolaj Frost; Jawed Nawabi; Julia Onken; Maximilian Schlaak; Jens-Uwe Blohmer; Uwe Pelzer; Ulrich Keller; Jalid Sehouli; Peter Vajkoczy; Ulrich Keilholz; Martin Misch
• Keywords: Cancer Research; Integrative Biomedicine [Topic 3]

Abstract Introduction and objectives Leptomeningeal disease (LMD) involves disseminating cancer cells to the leptomeninges cerebrospinal fluid. The impact of intracranial parenchymal brain metastases extracranial burden at LMD diagnosis remains unclear. This study evaluates these factors alongside local systemic therapies before after diagnosis. Methods A retrospective analysis was conducted on 188 patients diagnosed with between 2011 2024. Data demographics, imaging findings, treatments were collected. Kaplan–Meier estimates used for survival analysis, independent prognostic identified using a backward-stepwise Cox regression model. Results Primary cancers included breast (34.0%), non-small cell lung (22.3%), melanoma (14.4%). via MRI in 56.4% cases, fluid (CSF) cytology 2.7%, both 41.0%. Median overall 2.8 months [95% CI: 2.4 – 3.7]. Independent improved male sex (HR: 0.61 0.40 0.93], p = 0.020), absence hydrocephalus 0.42 0.22 0.79], 0.007), targeted therapy post-diagnosis 0.33 0.20 0.55], < 0.001). Two or more lines increased mortality risk 1.73 1.16 2.59], 0.007). Lack CNS also 0.51 0.30 0.89], 0.017). Pre-diagnosis radiation showed no benefit, while outcomes 0.47 0.32 0.70], Conclusion Absence use are favorable factors, extensive prior worsen outcomes. Tailored addressing crucial improving patients.