Proton craniospinal irradiation with bevacizumab and pembrolizumab for leptomeningeal disease: A case report

Mason J. Webb; William G. Breen; Nadia N. Laack; Konstantinos Leventakos; Jian L. Campian; Ugur Sener

doi:10.2217/cns-2023-0005

Proton craniospinal irradiation with bevacizumab and pembrolizumab for leptomeningeal disease: A case report

Mason J. Webb, William G. Breen, Nadia N. Laack, Konstantinos Leventakos, Jian L. Campian, Ugur Sener

Research output: Contribution to journal › Article › peer-review

Abstract

Leptomeningeal disease (LMD) remains a challenging condition with a dismal prognosis. In this case study, we report partial response of LMD in a patient with metastatic large cell neuroendocrine carcinoma following treatment with proton craniospinal irradiation (CSI), bevacizumab, and pembrolizumab. Two years after the initial diagnosis, he presented with LMD. He underwent proton CSI with bevacizumab followed by combination therapy with pembrolizumab and bevacizumab. He had a partial disease response with progression-free survival after LMD diagnosis of 4.6 months. He unfortunately developed pembrolizumab induced hypophysitis, after which he experienced rapid neurologic clinical progression. Overall, this novel combination led to a durable partial response which warrants prospective evaluation.

Original language	English (US)
Article number	CNS101
Journal	CNS oncology
Volume	12
Issue number	3
DOIs	https://doi.org/10.2217/cns-2023-0005
State	Published - Jul 26 2023

Keywords

bevacizumab
combination therapy
immune checkpoint inhibitor
leptomeningeal disease
pembrolizumab
proton craniospinal irradiation

ASJC Scopus subject areas

Neurology
Clinical Neurology

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10.2217/cns-2023-0005

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title = "Proton craniospinal irradiation with bevacizumab and pembrolizumab for leptomeningeal disease: A case report",

abstract = "Leptomeningeal disease (LMD) remains a challenging condition with a dismal prognosis. In this case study, we report partial response of LMD in a patient with metastatic large cell neuroendocrine carcinoma following treatment with proton craniospinal irradiation (CSI), bevacizumab, and pembrolizumab. Two years after the initial diagnosis, he presented with LMD. He underwent proton CSI with bevacizumab followed by combination therapy with pembrolizumab and bevacizumab. He had a partial disease response with progression-free survival after LMD diagnosis of 4.6 months. He unfortunately developed pembrolizumab induced hypophysitis, after which he experienced rapid neurologic clinical progression. Overall, this novel combination led to a durable partial response which warrants prospective evaluation.",

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author = "Webb, {Mason J.} and Breen, {William G.} and Laack, {Nadia N.} and Konstantinos Leventakos and Campian, {Jian L.} and Ugur Sener",

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AU - Laack, Nadia N.

AU - Leventakos, Konstantinos

AU - Campian, Jian L.

AU - Sener, Ugur

PY - 2023/7/26

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N2 - Leptomeningeal disease (LMD) remains a challenging condition with a dismal prognosis. In this case study, we report partial response of LMD in a patient with metastatic large cell neuroendocrine carcinoma following treatment with proton craniospinal irradiation (CSI), bevacizumab, and pembrolizumab. Two years after the initial diagnosis, he presented with LMD. He underwent proton CSI with bevacizumab followed by combination therapy with pembrolizumab and bevacizumab. He had a partial disease response with progression-free survival after LMD diagnosis of 4.6 months. He unfortunately developed pembrolizumab induced hypophysitis, after which he experienced rapid neurologic clinical progression. Overall, this novel combination led to a durable partial response which warrants prospective evaluation.

AB - Leptomeningeal disease (LMD) remains a challenging condition with a dismal prognosis. In this case study, we report partial response of LMD in a patient with metastatic large cell neuroendocrine carcinoma following treatment with proton craniospinal irradiation (CSI), bevacizumab, and pembrolizumab. Two years after the initial diagnosis, he presented with LMD. He underwent proton CSI with bevacizumab followed by combination therapy with pembrolizumab and bevacizumab. He had a partial disease response with progression-free survival after LMD diagnosis of 4.6 months. He unfortunately developed pembrolizumab induced hypophysitis, after which he experienced rapid neurologic clinical progression. Overall, this novel combination led to a durable partial response which warrants prospective evaluation.

KW - bevacizumab

KW - combination therapy

KW - immune checkpoint inhibitor

KW - leptomeningeal disease

KW - pembrolizumab

KW - proton craniospinal irradiation

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Proton craniospinal irradiation with bevacizumab and pembrolizumab for leptomeningeal disease: A case report

Abstract

Keywords

ASJC Scopus subject areas

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