Abstract Details

Title Leptomeningeal Metastasis and Renal Cell Carcinoma

Topic Neuro-oncology

Presentation(s) P1 - Poster Session 1 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-007

Objective

Describe presentation, management, and survival of patients with renal cell carcinoma (RCC) and leptomeningeal metastasis (LM) at MD Anderson Cancer Center.

Background

LM is an aggressive and rare complication of RCC, with few cases described in the literature. Data regarding this presentation is currently limited.

Design/Methods We describe our single center experience with patients with RCC and CSF cytology confirmed LM from January 2013 to July 2024.

Results Five cases were identified, with a median age of 65 years. Most patients had clear cell histology (4/5). LM presented with neurological symptoms in most (4/5), and included headache, cranial nerve IV and VII palsies, unilateral leg weakness, paraparesis, and urinary/bowel dysfunction. MRI revealed findings concerning for LM in both brain and spine in most patients (4/5). KPS was above 90 in 3 patients, and 50 and 60 in the other patients. Systemic disease was stable in most patients (4/5), and most were on active systemic treatment (4/5). Three patients had concomitant parenchymal metastases, in which 2 were present prior to the diagnosis of LM. Median time from RCC to LM diagnosis was 40 months (23.3-107.5 months). One patient was treated with bevacizumab followed by whole brain radiation, one with pazopanib, and one with focal radiation. One patient remains on treatment (intrathecal and intravenous nivolumab plus cabozantinib). Three patients were transitioned to hospice shortly after the diagnosis. Median survival after LM diagnosis was 3 months (1.4-5 months).

Conclusions LM from RCC is exceedingly rare. Survival following a diagnosis of LM is typically poor even with stable systemic disease, although one patient in our series continues treatment 5 months following the diagnosis. Our data provides the experience of a large cancer center in the US, and highlights some of the challenges of this rare diagnosis.

Authors/Disclosures
Catherine Garcia, MD (MD Anderson Cancer Center) PRESENTER	Dr. Garcia has nothing to disclose.
Keng Lam, MD (MD Anderson Neuro-Oncology)	Dr. Lam has nothing to disclose.
Ashley E. Aaroe, MD (MD Anderson Cancer Center)	Dr. Aaroe has nothing to disclose.
Nazanin Majd, MD (MD Anderson Cancer Center)	Dr. Nazanin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sumitomo Dainippon Pharma Oncology. Dr. Nazanin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celularity .
Amishi Shah, MD	Dr. Shah has nothing to disclose.
Nizar Tannir, MD	Dr. Tannir has nothing to disclose.
Martin Tom, MD	Dr. Tom has nothing to disclose.
Barbara O'Brien, MD (MD Anderson Cancer Center)	Dr. O'Brien has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PlusTherapeutics.

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