In the past, researchers have found it difficult to study leptomeningeal disease, a rare complication of late-stage cancer. Because researchers have lacked modeling systems to effectively study this condition, leptomeningeal disease often comes with a poor prognosis. Additionally, there are currently no therapeutic options. Typically, following diagnosis, patients live for approximately 3-6 months. However, researchers have recently made strides which could help improve patient outcomes.

According to Newswise, a research team from the Moffitt Cancer Center was able to develop tumor cell cultures. They developed these cultures using cerebrospinal fluid (CSF) sourced directly from patients. Previously, researchers were unable to culture these cells. In fact, even this research team acknowledges the difficulty behind culturing – which required a lot of patience and effort to find the perfect conditions. The team found that:

• Cultured leptomeningeal disease cells had a similar gene expression pattern to non-cultured cells. However, the cultured cells saw heightened IGFBP2 and IGF1R gene expression. These genes control cancer development processes. Thus, they represent a potential therapeutic target moving forward.
• Treating the cultured cells with ceritinib, an IGF1R inhibitor, slowed the growth of tumor cells. Researchers also treated mice models with ceritinib and saw the same results.
• When treating the cultured cells with ceritinib and trametinib, an MEK inhibitor, researchers saw how this combination treatment significantly inhibited tumor cell growth.

Now that the cultured cells have been developed, researchers are poised to expand their understanding of leptomeningeal disease and potential treatments. Hopefully, in the future, this helps to improve patient outcomes.

You can find the full study findings in Neuro-Oncology. 

What is Leptomeningeal Disease?

The Moffitt Cancer Center explains that leptomeningeal disease:

occurs when cancer (for example from a lung, breast or melanoma), or another area of the body spreads (metastasizes) to the cerebrospinal fluid or meninges. Cerebrospinal fluid is the liquid that transfers important nutrients to the brain and spinal cord, while meninges are layers of fine tissue that surround the brain and spinal cord.

Leptomeningeal disease may also be called meningeal metastases, leptomeningeal metastases, and carcinoma meningitis. Only an estimated 5-8% of those with cancer will develop leptomeningeal disease. Symptoms can include:

• Double vision
• Seizures
• Arm and leg pain, weakness, or loss of coordination
• Nausea and vomiting
• Dizziness and/or confusion
• A progressively worsening headache
• Difficulty thinking, speaking, or swallowing
• Loss of bladder and/or bowel control
• Fatigue and/or lethargy