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28 February 2017 : Case report  Italy

Metronomic Capecitabine Effectively Blocks Leptomeningeal Carcinomatosis From Breast Cancer: A Case Report and Literature Review

Unusual clinical course, Unusual or unexpected effect of treatment, Unexpected drug reaction, Educational Purpose (only if useful for a systematic review or synthesis)

Michela Maur1AE, Claudia Omarini1EF*, Federico Piacentini1AE, Annalisa Fontana1F, Elisa Pettorelli1BD, Stefano Cascinu1DE

DOI: 10.12659/AJCR.901812

Am J Case Rep 2017; 18:208-211

Abstract

BACKGROUND: Meningeal carcinomatosis is a rare complication in breast cancer patients. At present, there are no defined guidelines for its management. The efficacy of systemic treatment seems to depend on its ability to cross the blood-brain-barrier and its interaction with tumor vasculature. Metronomic chemotherapy is a known modality of drug administration able to inhibit tumor angiogenesis.

CASE REPORT: We present a case of symptomatic leptomeningeal carcinomatosis from breast cancer successfully treated with capecitabine. Based on the hypothesis that angiogenesis contributes to neoplastic meningitis, the patient was treated with a metronomic schedule that provided long-term clinical benefit with a very low toxicity profile.

CONCLUSIONS: To assess the real impact of metronomic chemotherapy in patients with meninges involvement, a phase II study will be starting soon in our institution. A review of the literature concerning the management of meningeal carcinomatosis is also presented.

Keywords: Administration, Metronomic, Meningeal Carcinomatosis

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923