IMMU-78. A new era in leptomeningeal disease (LMD): recent advancements in immune therapies and radiotherapy in melanoma LMD, what has been done and future directions

Abstract Leptomeningeal disease (LMD) arises as a metastatic complication from tumor cells in-vading the leptomeninges and cerebrospinal fluid (CSF). Advances in targeted and immune thera-pies in the last decade have not translated to this disease and the prognosis for these patients remains dismal. Melanoma is one of the most common etiologies of LMD, however specific devel-opments for this complication still represent a huge gap in research. Recent clinical trials have evaluated different routes of drug delivery (i.e., systemic versus intrathecal), drug types (i.e., immune checkpoint inhibitors [ICIs], small molecule inhibitors), and radiation therapy modalities with varied results and still limited data. Here we summarize recent advances in therapies for patients with LMD, including clinical trials, focusing on radiation therapy and ICI therapies in LMD from melanoma (M-LMD). We found challenges that need to be overcome to improve research including the limited amount of patients with M-LMD accrued into clinical trials and limited access to specialized therapies This could potentially open additional research avenues in the near future as we better understand the intricacies of LMD, ultimately providing patients with better odds of survival.