[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-336463-105":59,"doc-detail-336463-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","drug-delivery-in-leptomeningeal-disease-navigating-barriers-and-beyond-review-article","Drug delivery in leptomeningeal disease - Navigating barriers and beyond - Review Article","","Leptomeningeal disease (LMD) is the infiltration of cancer cells into the leptomeningeal space and cerebrospinal fluid. Its diffuse spread, heterogeneous phenotypes, and the inadequacy of uniform targeting complicate diagnosis and management. Standard intrathecal chemotherapy can lead to treatment-related complications, poor compliance, and suboptimal distribution. Systemic administration requires crossing fluid barriers but may produce off-target effects and subtherapeutic CNS concentrations. Advances such as liposomal cytarabine improve delivery, yet further progress is needed.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/drug-delivery-in-leptomeningeal-disease-navigating-barriers-and-beyond-review-article/336463/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/drug-delivery-in-leptomeningeal-disease-navigating-barriers-and-beyond-review-article/336463.png","ImageObject",300,407,{"name":92,"@type":93},"Aria","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is leptomeningeal disease (LMD) and why is it difficult to manage?","Question",{"text":112,"@type":113},"LMD involves infiltration of cancer cells into the leptomeningeal layers and cerebrospinal fluid. Its diffuse spread and mixed tumor phenotypes make effective diagnosis and drug delivery challenging.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why is standard intrathecal chemotherapy not fully sufficient for LMD?",{"text":117,"@type":113},"Intrathecal delivery is linked to treatment-related complications, low patient compliance, and suboptimal drug distribution across the leptomeningeal space.",{"name":119,"@type":110,"acceptedAnswer":120},"What limitations come with systemic drug delivery for LMD?",{"text":121,"@type":113},"Systemic administration can cause off-target effects and may result in subtherapeutic drug concentrations within the central nervous system after crossing fluid barriers.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},336463,1790445122,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},2336464648322,"https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488","Drug Delivery  \n2024, vOl. 31, NO. 1, 2375521  \n[https://doi.org/10.1080/10717544.2024.2375521](https://doi.org/10.1080/10717544.2024.2375521)  \nReview ARticle    \nDrug delivery in leptomeningeal disease: Navigating barriers and beyond  \nNumair Arshada, Nupur Biswasa,b, Jaya Gillb, Santosh Kesaric and Shashaanka Ashilib  \narhenix lifesciences, Hyderabad, Telangana, india; bCureScience, San Diego, California, uSA; cDepartment of Translational Neurosciences, Pacific Neuroscience institute and Saint John’s Cancer institute at Providence Saint John’s Health Center, Santa Monica, California, uSA  \nABSTRACT  \nleptomeningeal disease (lMD) refers to the infiltration of cancer cells into the leptomeningeal compartment. leptomeninges are the two membranous layers, called the arachnoid membrane and pia mater. the diffuse nature of lMD poses a challenge to its effective diagnosis and successful management. Furthermore, the predominant phenotype; solid masses or freely floating cells, has altering implications on the effectiveness of drug delivery systems. the standard of care is the intrathecal delivery of chemotherapy drugs but it is associated with increased instances of treatment-related complications, low patient compliance, and suboptimal drug distribution. An alternative involves administering the drugs systemically, after which they must traverse fluid barriers to arrive at their destination within the leptomeningeal space. However, this route is known to cause off-target effects as well as produce subtherapeutic drug concentrations at the target site within the central nervous system. the development of new drug delivery systems such as liposomal cytarabine has improved drug delivery in leptomeningeal metastatic disease, but much still needs to be done to effectively target this challenging condition. in this review, we discuss about the anatomy of leptomeninges relevant for drug penetration, the conventional and advanced drug delivery methods for lMD. we also discuss the future directions being set by different clinical trials.  \nGRAPHICAL ABSTRACT  \nARTICLE HISTORY  \nReceived 4 December 2023  \nRevised 25 June 2024 Accepted 27 June 2024  \nKEYWORDS  \nleptomeningeal disease; neoplastic meningitis; leptomeninges; cNS metastasis; intrathecal chemotherapy; leptomeningeal metastasis  \nIntroduction  \nleptomeningeal disease (lMD), also known as neoplastic meningitis, is a late complication of cancer in which tumor cells from a primary cancer are disseminated to the leptomeningeal layers and the cerebrospinal fluid (cSF) . when a tumor is advanced enough, some of the cancer cells metastasize to other parts of the body including the leptomeningeal compartment which offers them pharmacological shelter against the normal concentrations of anticancer drugs in the systemic circulation. Furthermore,  \nthe cancer cells do not always form distinct masses making it difficult to surgically remove them or target them through cytotoxic radiation. this occurs because, once within the leptomeningeal compartment, certain cancer cells gather into small clusters along the leptomeninges, while others remain suspended within the cSF (Remsik et al., 2022) . Any cytotoxic agent should be repeatedly aimed at the entire neuraxis which is associated with serious off-target effects leading to a decrease in the quality of life of the patients. therefore, the effective and safe delivery of anticancer drugs that accurately target  \nCONTACT Nupur Biswas  [nupur@rhenix.org](nupur@rhenix.org), [nupurbiswas@gmail.com](nupurbiswas@gmail.com)  rhenix lifesciences, Hyderabad 500038, Telangana, india.  \n© 2024 rhenix lifesciencesCureScience. Published by informa uK limited, trading as Taylor & Francis group.  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial license ([http://creativecommons.org/licenses/by-nc/4.0/](http://creativecommons.org/licenses/by-nc/4.0/)), which permits unrestricted non-commercial use, dist","cbCaihgAk60KozEj","https://ap.wps.com/l/cbCaihgAk60KozEj","pdf",974540,11,"English","# Introduction\n## Leptomeningeal disease definition and clinical relevance\n## Challenges in diagnosis and treatment targeting\n# Drug delivery approaches\n## Intrathecal chemotherapy limitations\n## Systemic delivery and barrier traversal\n## Emerging and advanced delivery systems\n# Future directions\n## Guidance from clinical trials","[{\"question\":\"What is leptomeningeal disease (LMD) and why is it difficult to manage?\",\"answer\":\"LMD involves infiltration of cancer cells into the leptomeningeal layers and cerebrospinal fluid. Its diffuse spread and mixed tumor phenotypes make effective diagnosis and drug delivery challenging.\"},{\"question\":\"Why is standard intrathecal chemotherapy not fully sufficient for LMD?\",\"answer\":\"Intrathecal delivery is linked to treatment-related complications, low patient compliance, and suboptimal drug distribution across the leptomeningeal space.\"},{\"question\":\"What limitations come with systemic drug delivery for LMD?\",\"answer\":\"Systemic administration can cause off-target effects and may result in subtherapeutic drug concentrations within the central nervous system after crossing fluid barriers.\"}]","Drug delivery in leptomeningeal disease - Navigating barriers and beyond - Review Article | PDF",1790015148,28]