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Melanoma: HELP
Articles by Emilie Le Rhun
Based on 12 articles published since 2008
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Between 2008 and 2019, É. Le Rhun wrote the following 12 articles about Melanoma.
 
+ Citations + Abstracts
1 Guideline [ANOCEF guidelines for the management of brain metastases]. 2015

Le Rhun, É / Dhermain, F / Noël, G / Reyns, N / Carpentier, A / Mandonnet, E / Taillibert, S / Metellus, P / Anonymous2980820. ·Neuro-oncologie, département de neurochirurgie, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, 59037 Lille cedex, France; Oncologie médicale, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France; Laboratoire Prism, université Lille 1, Inserm U1192, bâtiment SN3 1(er) étage, 59655 Villeneuve d'Ascq cedex, France; Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC) , 13273 Marseille cedex 09, France. Electronic address: emilie.lerhun@chru-lille.fr. · Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC) , 13273 Marseille cedex 09, France; Département de radiothérapie, institut de cancérologie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France; Réunion de concertation pluridisciplinaire de neuro-oncologie, institut de cancérologie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France. · Département universitaire de radiothérapie, centre de lutte contre le cancer Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, BP 42, 67065 Strasbourg cedex, France; Laboratoire EA 3430, fédération de médecine translationnelle de Strasbourg (FMTS), université de Strasbourg, 4, rue Kirschleger, 67085 Strasbourg cedex, France. · Département de neurochirurgie, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, 59037 Lille cedex, France. · Service de neurologie, hôpital Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), 125, rue de Stalingrad, 93009 Bobigny cedex, France. · Département de neurochirurgie, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France. · Département de neurologie 2, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Département de radiothérapie, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Université Pierre-et-Marie-Curie Paris VI, 4, place Jussieu, 75005 Paris, France. · Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC) , 13273 Marseille cedex 09, France; Département de neurochirurgie, centre hospitalo-universitaire La Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France; Centre de recherche en oncologie et oncopharmacologie (CRO2), faculté de médecine Timone, université Aix-Marseille, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France; Inserm U911, faculté de médecine Timone, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France. ·Cancer Radiother · Pubmed #25666314.

ABSTRACT: The incidence of brain metastases is increasing because of the use of new therapeutic agents, which allow an improvement of overall survival, but with only a poor penetration into the central nervous system brain barriers. The management of brain metastases has changed due to a better knowledge of immunohistochemical data and molecular biological data, the development of new surgical, radiotherapeutic approaches and improvement of systemic treatments. Most of the time, the prognosis is still limited to several months, nevertheless, prolonged survival may be now observed in some sub-groups of patients. The main prognostic factors include the type and subtype of the primitive, age, general status of the patient, number and location of brain metastases, extracerebral disease. The multidisciplinary discussion should take into account all of these parameters. We should notice also that treatments including surgery or radiotherapy may be proposed in a symptomatic goal in advanced phases of the disease underlying the multidisciplinary approach until late in the evolution of the disease. This article reports on the ANOCEF (French neuro-oncology association) guidelines. The management of brain metastases of breast cancers and lung cancers are discussed in the same chapter, while the management of melanoma brain metastases is reported in a separate chapter due to different responses to the brain radiotherapy.

2 Review Neoplastic Meningitis Due to Lung, Breast, and Melanoma Metastases. 2017

Le Rhun, Emilie / Taillibert, Sophie / Chamberlain, Marc C. ·Division of Neuro-Oncology in the Department of Neurosurgery, University Hospital and the Breast Unit in the Department of Medical Oncology, Oscar Lambret Center, Lille Cedex, France. · Division of Neuro-Oncology in the Departments of Neurology, and Radiation Oncology, Pitie-Salpetriere Hospital, and Assistance Publique des Hopitaux de Paris, Universite Pierre et Marie Curie, Paris, France. · Department of Neurology, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, and Division of Neuro-Oncology, Departments of Neurology and Neurological Surgery, University of Washington School of Medicine, Seattle, WA. marccchamberlain@gmail.com. ·Cancer Control · Pubmed #28178709.

ABSTRACT: BACKGROUND: Neoplastic meningitis, a central nervous system (CNS) complication of cancer metastatic to the meninges and cerebrospinal fluid (CSF), is relevant to oncologists due to the impact of the disease on patient quality of life and survival rates. METHODS: A review of the literature of articles published in English was conducted with regard to neoplastic meningitis. RESULTS: The incidence of neoplastic meningitis is increasing because patients with cancer are surviving longer in part because of the use of novel therapies with poor CNS penetration. Up to 5% of patients with solid tumors develop neoplastic meningitis during the disease course (breast cancer, lung cancer, and melanoma being the predominantly causative cancers). The rate of median survival in patients with untreated neoplastic meningitis is 1 to 2 months, although it can be as long as 5 months in some cases. Therapeutic options for the treatment of neoplastic meningitis include systemic therapy (cancer-specific, CNS-penetrating chemotherapy or targeted therapies), intra-CSF administration of chemotherapy (methotrexate, cytarabine, thiotepa) and CNS site-specific radiotherapy. Determining whom to treat with neoplastic meningitis remains challenging and, in part, relates to the extent of systemic disease, the neurological burden of disease, the available systemic therapies, and estimated rates of survival. CONCLUSIONS: The prognosis of neoplastic meningitis remains poor. The increasing use of novel, targeted therapies and immunotherapy in solid tumors and its impact on neoplastic meningitis remains to be determined and is an area of active research. Thus, well conducted trials are needed.

3 Review Leptomeningeal metastases of solid cancer. 2016

Le Rhun, Emilie / Galanis, Evanthia. ·aBreast Unit, Department of Medical Oncology, Oscar Lambret Center bNeuro-oncology, Department of Neurosurgery, University Hospital cLille University, Inserm U-1192, Laboratoire de Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM), Lille, France dDepartment of Oncology, Mayo Clinic, Rochester, Minnesota, USA. ·Curr Opin Neurol · Pubmed #27661208.

ABSTRACT: PURPOSE OF REVIEW: To review recent original data on leptomeningeal metastases in patients with solid cancer. RECENT FINDINGS: Lung and breast cancer as well as melanoma remain the most common primaries. Advanced cytological methods and targeted sequencing for candidate tumor-specific mutations may improve the sensitivity of cerebrospinal fluid diagnostics in leptomeningeal metastases. Targeted treatments like epidermal growth factor receptor tyrosine kinase inhibitors for non-small cell lung cancer, anti-human epidermal growth factor receptor-2 treatments for breast cancer or B-rapidly accelerated fibrosarcoma-targeted or immunotherapy for melanoma have an emerging role in the management of this condition. SUMMARY: Novel diagnostic approaches and the introduction of targeted agents may improve the clinical management of patients with leptomeningeal metastases from solid cancers.

4 Review [Systemic treatment of melanoma brain metastases]. 2015

Le Rhun, É / Mateus, C / Mortier, L / Dhermain, F / Guillot, B / Grob, J-J / Lebbe, C / Thomas, M / Jouary, T / Leccia, M-T / Robert, C. ·Neuro-oncologie, département de neurochirurgie, hôpital Roger-Salengro, CHRU, rue Émile-Laine, 59037 Lille cedex, France; Oncologie médicale, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France; Inserm U1192, laboratoire Prism, université Lille 1, bâtiment SN3 1(er) étage, 59655 Villeneuve-d'Ascq cedex, France; Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC), 13273 Marseille cedex 09, France. Electronic address: emilie.lerhun@chru-lille.fr. · Département de dermatologie, institut de cancérologie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France. · Département de dermatologie, centre hospitalier régional et universitaire de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France. · Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC), 13273 Marseille cedex 09, France; Département de radiothérapie, institut de cancérologie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France; Réunion de concertation pluridisciplinaire de neuro-oncologie, institut de cancérologie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France. · Département de dermatologie, centre hospitalier universitaire, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France; Université Montpellier 1, 5, boulevard Henri-IV, CS 19044, 34967 Montpellier cedex 2, France. · Département de dermatologie, centre hospitalo-universitaire, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France. · Département de dermatologie, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, 1, avenue Claude-Vellefaux, 75010 Paris, France. · Service de dermatologie, pôle d'oncologie-radiothérapie, de dermatologie et des soins palliatifs, groupe hospitalier Saint-André, centre hospitalier universitaire de Bordeaux, 1, rue Jean-Burguet, 33075 Bordeaux, France. · Clinique de dermatologie, d'allergologie et de photobiologie, centre hospitalier Albert-Michallon, boulevard de la Chantourne, BP 217, 38043 Grenoble cedex 9, France; Inserm U832, institut A.-Bonniot, 38043 Grenoble cedex 09, France. ·Cancer Radiother · Pubmed #25656856.

ABSTRACT: Melanomas have a high rate of brain metastases. Both the functional prognosis and the overall survival are poor in these patients. Until now, surgery and radiotherapy represented the two main modalities of treatment. Nevertheless, due to the improvement in the management of the extracerebral melanoma, the systemic treatment may be an option in patients with brain metastases. Immunotherapy with anti-CTLA4 (cytotoxic T-lymphocyte-associated protein 4) - ipilimumab - or BRAF (serine/threonine-protein kinase B-raf) inhibitors - vemurafenib, dabrafenib - has shown efficacy in the management of brain metastases in a- or pauci-symptomatic patients. Studies are ongoing with anti-PD1 (programmed cell death 1) and combinations of targeted therapies associating anti-RAF (raf proto-oncogene, serine/threonine kinase) and anti-MEK (mitogen-activated protein kinase kinase).

5 Review [Brain metastases imaging]. 2015

Delmaire, C / Savatovsky, J / Boulanger, T / Dhermain, F / Le Rhun, E / Météllus, P / Gerber, S / Carsin-Nicole, B / Petyt, G. ·Service de neuroradiologie, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, 59037 Lille cedex, France. · Service de neuroradiologie, fondation Rothschild, 78, rue de Picpus, 75012 Paris, France. · Service de radiologie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France. · Service de radiothérapie, institut de cancérologie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France. · Neuro-oncologie, département de neurochirurgie, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, 59037 Lille cedex, France; Oncologie médicale, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France; Laboratoire Prism, université Lille 1, bâtiment SN3 1(er) étage, 59655 Villeneuve-d'Ascq cedex, France; Inserm U1192, 59655 Villeneuve-d'Ascq cedex, France; Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC), 13273 Marseille cedex 09, France. · Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC), 13273 Marseille cedex 09, France; Département de neurochirurgie, CHU La Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France; Centre de recherche en oncologie et oncopharmacologie (CRO2), faculté de médecine Timone, université Aix-Marseille, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France; Inserm U911, faculté de médecine Timone, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France. Electronic address: philippe.metellus@mail.ap-hm.fr. · Service de neuroradiologie, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France. · Service de neuroradiologie, CHU de Rennes, 2, rue Henri-Le Guilloux, 35033 Rennes cedex 9, France. · Service de médecine nucléaire, centre Oscar-Lambret, CHRU de Lille, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France. ·Cancer Radiother · Pubmed #25649387.

ABSTRACT: The therapeutic management of brain metastases depends upon their diagnosis and characteristics. It is therefore imperative that imaging provides accurate diagnosis, identification, size and localization information of intracranial lesions in patients with presumed cerebral metastatic disease. MRI exhibits superior sensitivity to CT for small lesions identification and to evaluate their precise anatomical location. The CT-scan will be made only in case of MRI's contraindication or if MRI cannot be obtained in an acceptable delay for the management of the patient. In clinical practice, the radiologic metastasis evaluation is based on visual image analyses. Thus, a particular attention is paid to the imaging protocol with the aim to optimize the diagnosis of small lesions and to evaluate their evolution. The MRI protocol must include: 1) non-contrast T1, 2) diffusion, 3) T2* or susceptibility-weighted imaging, 4) dynamic susceptibility contrast perfusion, 5) FLAIR with contrast injection, 6) T1 with contrast injection preferentially using the 3D spin echo images. The role of the nuclear medicine imaging is still limited in the diagnosis of brain metastasis. The Tc-sestamibi brain imaging or PET with amino acid tracers can differentiate local brain metastasis recurrence from radionecrosis but still to be evaluated.

6 Review [Epidemiology of brain metastases]. 2015

Taillibert, S / Le Rhun, É. ·Service de neurologie 2, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Université Pierre-et-Marie-Curie, 4, place Jussieu, 75005 Paris, France; Radiothérapie, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France. · Neuro-oncologie, département de neurochirurgie, hôpital Roger-Salengro, CHRU, rue Émile-Laine, 59037 Lille cedex, France; Oncologie médicale, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France; Inserm U1192, laboratoire Prism, université Lille 1, bâtiment SN3 1(e) étage, 59655 Villeneuve d'Ascq cedex, France; Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC), 13273 Marseille cedex 09, France. Electronic address: emilie.lerhun@chru-lille.fr. ·Cancer Radiother · Pubmed #25636729.

ABSTRACT: The most frequent intracranial brain tumours are brain metastases. All types of cancer can develop brain metastases but two thirds of brain metastases occurring in adult patients are secondary to one of these three cancers: lung cancer, breast cancer and melanoma. In accordance with these data, this review is focusing on the epidemiology of these three types of cancer. We report here the incidence, risk factors, median time of brain metastases occurrence after diagnosis of the primary cancer, prognosis and median survival for these three types of cancer. We also discuss the clinical implications of these data. The second part of this review is focusing on the Graded Prognostic Assessment scores in all types of primary cancer with brain metastases, how they can be applied in clinical research for a better stratification of patients, and to some extent in clinical practice to guide decisions for personalized treatments. These scores provide a better understanding of the different profiles of clinical evolution that can be observed amongst patients suffering from brain metastases according to the type of primary cancer. We highlighted the most remarkable and useful clinical implications of these data.

7 Article Chemical meningitis related to intra-CSF liposomal cytarabine. 2017

Durand, Bénédicte / Zairi, Fahed / Boulanger, Thomas / Bonneterre, Jacques / Mortier, Laurent / Le Rhun, Emilie. ·Lille University, F-59000 Lille, France. · Oscar Lambret Center, Medical Oncology Department, F-59000 Lille, France. · Inserm, U-1192, F-59000 Lille, France. · CHU Lille, Neurosurgery Department, F-59000Lille, France. · Oscar Lambret Center, Department of Radiology, F-59000 Lille, France. · CHU Lille, Dermatology Department, F-59000Lille, France. ·CNS Oncol · Pubmed #29057672.

ABSTRACT: Therapeutic options of leptomeningeal metastases include intra-cerebrospinal fluid (CSF) chemotherapy. Among intra-CSF agents, liposomal cytarabine has advantages but can induce specific toxicities. A BRAF-V600E-mutated melanoma leptomeningeal metastases patient, treated by dabrafenib and liposomal cytarabine, presented after the first injection of liposomal cytarabine with hyperthermia and headaches. Despite sterile CSF/blood analyses, extended intravenous antibiotics were given and the second injection was delayed. The diagnosis of chemical meningitis was finally made. Dose reduction and appropriate symptomatic treatment permitted the administration of 15 injections of liposomal cytarabine combined with dabrafenib. A confirmation of the diagnosis of chemical meningitis is essential in order (1) not to delay intra-CSF or systemic chemotherapy or (2) to limit the administration of unnecessary but potentially toxic antibiotics.

8 Article Complications related to the use of an intraventricular access device for the treatment of leptomeningeal metastases from solid tumor: a single centre experience in 112 patients. 2015

Zairi, Fahed / Le Rhun, Emilie / Bertrand, Nicolas / Boulanger, Thomas / Taillibert, Sophie / Aboukais, Rabih / Assaker, Richard / Chamberlain, Marc C. ·Department of Neurosurgery, Hopital Roger Salengro, Lille University Hospital, Rue Emile Laine, 59037, Lille, France. fahed.zairi@gmail.com. · Department of Neurosurgery, Hopital Roger Salengro, Lille University Hospital, Rue Emile Laine, 59037, Lille, France. · Department of Medical Oncology, Oscar Lambret Center, Lille, France. · Department of Radiology, Oscar Lambret Center, Lille, France. · Department of Neuro-Oncology Mazarin, Pitie-Salpetriere Hospital, Paris, France. · Department of Radiation Oncology, Pitie-Salpetriere Hospital, Paris, France. · Department of Neurology, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA. ·J Neurooncol · Pubmed #26070555.

ABSTRACT: Ventricular access devices (VAD) offer several advantages compared to intralumbar injections for the administration of intra-CSF agents in the treatment of leptomeningeal metastases (LM). However, there are few prospective studies reporting on complications with the use of VADs. All complications were prospectively collected that pertained to the implantation and use of a VAD in consecutive patients with solid tumor-related LM from June 2006 to December 2013. Clinical follow-up was every 2 weeks during the initial 2 months of treatment and then once monthly. Complete neuraxis MRI was performed at baseline and then every 2-3 months. A total of 112 patients (88 women) with a mean age of 51.1 years (range 26-73) were included. Primary cancers included breast (79 patients), lung (12) and melanoma (6). All patients were treated with intra-CSF liposomal cytarabine. 72 % of the patients received concomitant systemic and intra-CSF chemotherapy. The placement of the VAD was performed under local anesthesia in all cases. The mean operative time was 15 min and no perioperative complications were reported. The mean number of intraventricular injections per patient was 9.34 (range 1-47). A total of 11 complications in 11 patients were seen including 7 infections, 1 intracranial hemorrhage, 2 instances of symptomatic leukoencephalopathy and 1 catheter malpositioning. 8 complications required an operation and 1 complication was fatal. The use of a VAD is safe and may improve patients' comfort and compliance with LM-directed therapy.

9 Article Cerebrospinal fluid concentrations of vemurafenib in patients treated for brain metastatic BRAF-V600 mutated melanoma. 2015

Sakji-Dupré, Lilia / Le Rhun, Emilie / Templier, Carole / Desmedt, Eve / Blanchet, Benoit / Mortier, Laurent. ·Departments of aDermatology bNeuro-Oncology, Lille Regional Teaching Hospital cDepartment of Neuro-Oncology, Oscar Lambret Cancer Research Center, Lille dPharmacokinetics and Pharmacochemistry Unit, Paris Public Hospital System, Cochin Hospital, Paris, France. ·Melanoma Res · Pubmed #25933211.

ABSTRACT: Anti-BRAF agents, including vemurafenib, have modified the prognosis for patients with melanoma. However, a difference can still be observed between extracerebral and cerebral responses. The aim of this study was to investigate the diffusion of vemurafenib in cerebrospinal fluid (CSF) from patients treated for brain metastatic BRAF-V600 mutated melanoma. Six patients treated with vemurafenib 960 mg twice daily were included. These patients had undergone a lumbar puncture because of suspicions of leptomeningeal metastasis, along with simultaneous blood sampling to measure vemurafenib level. The concentrations of vemurafenib in the CSF and the plasma were measured by high-performance liquid chromatography. The mean plasma and CSF concentrations of vemurafenib were 53.4±26.2 and 0.47±0.37 mg/l, respectively. The mean ratio of the CSF : plasma concentration was 0.98±0.84%. No relationship was found between plasma and CSF concentrations (P=0.8). In conclusion, our preliminary results highlight for the first time a low CSF vemurafenib penetration rate associated with a large interindividual variability in patients treated for metastatic BRAF-V600 mutated melanoma and brain metastases. Further investigations with larger cohorts are required to study the relationship between CSF vemurafenib concentrations and cerebral response.

10 Article [Limbic encephalitis: a new paraneoplastic auto-immune manifestation associated with metastatic melanoma?]. 2013

Becquart, C / Ryckewaert, G / Desmedt, E / Defebvre, L / Le Rhun, E / Mortier, L. ·Service de dermatologie, hôpital Claude-Huriez, rue Michel-Polonovski, 59037 Lille cedex, France. coralie.becquart@univ-lille2.fr ·Ann Dermatol Venereol · Pubmed #23567229.

ABSTRACT: BACKGROUND: Several studies indicate an association between immune-related manifestations and prolonged survival in metastatic melanoma. Limbic encephalitis driven by immune-mediated disorders may also be observed during the course of certain cancers. PATIENTS AND METHODS: In November 2009, a 60-year-old woman followed up for metastatic melanoma since July 2005 developed rapidly progressive cognitive disorder. Clinical, biological, MRI and electroencephalogram abnormalities resulted in diagnosis of probably paraneoplastic limbic encephalitis in a context of immune-related manifestations although chemotoxicity could not be ruled out. Auto-immunity with hypothyroidism and thrombocytopenia were seen concomitantly. DISCUSSION: To the best of our knowledge, this is the first reported case of probably paraneoplastic limbic encephalitis associated with melanoma, a new example of an immune-related condition associated with prolonged survival in metastatic melanoma.

11 Article Detection and quantification of CSF malignant cells by the CellSearch technology in patients with melanoma leptomeningeal metastasis. 2013

Le Rhun, Emilie / Tu, Qian / De Carvalho Bittencourt, Marcelo / Farre, Isabelle / Mortier, Laurent / Cai, Huili / Kohler, Chantal / Faure, Gilbert C. ·Neurology, Breast Unit, Department of Medical Oncology, Oscar Lambret Center, 3 rue F Combemale, 59020 Lille Cedex, France. E-lerhun@o-lambret.fr ·Med Oncol · Pubmed #23504338.

ABSTRACT: Melanoma is the most frequent solid tumor associated with leptomeningeal metastasis (LM). The usual diagnostic tools, that is, cytomorphological assessment of cerebro-spinal fluid (CSF) and gadolinium-enhanced MRI of the entire neuraxis both lack effectiveness. The CellSearch Veridex technology for the detection of circulating tumor cells (CTC) in blood was designed for the follow-up and prognosis of breast, prostate, colorectal, and lung cancer, which express EpCAM markers. We have previously adapted this technology to detect malignant cells in the CSF of breast cancer LM. Our objective here was to check if this technology would also allow the detection and the enumeration of CTC in the CSF of melanoma patients presenting with LM although melanoma does not express EpCAM markers. On the occasion of the intrathecal treatment of LM in 2 melanoma patients, 5 mL of CSF and 7.5 mL of blood were collected on CellSave Preservative Tubes and analyzed within 3 days after CSF sampling using a melanoma-dedicated kit. The CellSearch Veridex technology was then adapted to direct enrichment, enumeration, and visualization of melanoma cells in the CSF. CD146+, HMW-MAA+, CD34-, and CD45- cells with typical morphology could be observed and enumerated sequentially with reproducible results, corresponding to CSF melanoma cells (CSFMC). In contrast to the current gold standard cytomorphological analysis, this new approach allowed a precise quantification of CSFMC in all samples concomitantly analyzed. This methodology, established on a limited volume of sample and allowing delayed processing, could prove of great interest in the diagnosis and follow-up of melanoma patients with LM.

12 Article Leptomeningeal metastasis in melanoma: a prospective clinical study of nine patients. 2012

Pape, Emeline / Desmedt, Eve / Zairi, Fahed / Baranzelli, Marie-Christine / Dziwniel, Veronique / Dubois, François / Bonneterre, Jacques / Mortier, Laurent / Le Rhun, Emilie. ·Department of Dermatology, Huriez Hospital, Regional and University Hospital, Lille, France. ·In Vivo · Pubmed #23160697.

ABSTRACT: BACKGROUND: Melanoma has the highest rate of spread to the leptomeninges and the incidence of melanoma has been steadily rising. This article describes recent experience at the Lille University Hospital, between 2007 and 2011 and discusses the possibilities for treatment of leptomeningeal metastasis. PATIENTS AND METHODS: Nine patients were diagnosed with leptomeningeal metastasis of melanoma. The standard criteria were used for the diagnosis. The treatment consisted of a combination of intrathecal chemotherapy, systemic chemotherapy and best supportive care. RESULTS: The overall median survival from the time of leptomeningeal metastasis diagnosis was eight weeks (range=1-168 weeks). In two cases, the median overall survival was 104 weeks. For these patients, there was a clear benefit in intrathecal chemotherapy combined with systemic treatment. No complication was observed. CONCLUSION: Despite a poor prognosis, treatment of melanoma leptomeningeal metastasis is needed in order to improve the quality of life, neurological progression-free survival and overall survival of patients.