Efficacy of Liposomal Cytarabine in the Treatment of Leptomeningeal Metastasis of Breast Cancer

BACKGROUND: Breast cancer is one of the most frequent causes of leptomeningeal metastasis (LM) among solid tumors in adults. The prognosis of patients with LM is poor. A treatment option is the intrathecal administration of liposomal cytarabine.

CASE REPORTS: The first case represents a 53-year-old woman with LM of breast cancer. A neurological response was achieved shortly after the start of the multimodal treatment including intrathecal liposomal cytarabine. The response duration reached 79 days. The second case represents a 48-year-old woman with LM of breast cancer treated with intrathecal liposomal cytarabine as a part of a multimodal treatment approach. A neurological response was achieved in the first 2 weeks of treatment and is still lasting after 18 months.

CONCLUSION: These cases suggest that a rapid response to a prompt start of treatment with intrathecal liposomal cytarabine in patients with LM of breast cancer is feasible. In 1 case an extremely long progression-free survival (18+ months) was achieved. The cases support the efficacy of liposomal cytarabine in the management of LM in breast cancer patients as a part of a multimodal treatment approach and underline the need for further investigations in this specific cohort.