: Leptomeningeal metastasis (LM) is a serious and often fatal complication in patients with advanced lung cancer, resulting in significant neurological deficits, decreased quality of life, and a poor prognosis. This article summarizes current research advances in treating lung cancer with meningeal metastases, discusses clinical challenges, and explores treatment strategies. Through an extensive review of relevant clinical trial reports and screening of recent conference abstracts, we collected clinical data on treating patients with lung cancer with meningeal metastases to provide an overview of the current research progress. Exciting progress has been made by focusing on specific mutations within lung cancer, including the use of EGFR tyrosine kinase inhibitors or inhibitors for anaplastic lymphoma kinase gene rearrangement, such as osimertinib, alectinib, and lorlatinib. These targeted therapies have shown impressive results in penetrating the central nervous system (CNS). Regarding whole-brain radiotherapy, there is currently some controversy among investigators regarding its effect on survival. Additionally, immune checkpoint inhibitors (ICIs) have demonstrated reliable clinical benefits due to their ability to retain anticancer activity in CNS metastases. Moreover, combination therapy shows promise in providing further treatment possibilities. Considerable progress has been made in the clinical research of lung cancer with LM. However, the sample size of prospective clinical trials investigating LM for lung cancer is still limited, with most reports being retrospective. Developing more effective management protocols for metastatic LM in lung cancer remains an ongoing challenge for the future.

中文翻译：

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肺癌软脑膜转移的治疗进展

：软脑膜转移（LM）是晚期肺癌患者的一种严重且常常致命的并发症，导致显着的神经功能缺损、生活质量下降和预后不良。本文总结了当前肺癌脑膜转移治疗的研究进展，讨论了临床挑战，并探讨了治疗策略。通过广泛查阅相关临床试验报告和筛选近期会议摘要，我们收集了治疗肺癌脑膜转移患者的临床数据，以概述当前的研究进展。通过关注肺癌内的特定突变，已经取得了令人兴奋的进展，包括使用 EGFR 酪氨酸激酶抑制剂或间变性淋巴瘤激酶基因重排抑制剂，如奥西替尼、艾来替尼和劳拉替尼。这些靶向疗法在穿透中枢神经系统（CNS）方面显示出令人印象深刻的结果。关于全脑放疗，目前研究人员对其对生存的影响存在一些争议。此外，免疫检查点抑制剂（ICIs）由于能够在中枢神经系统转移中保留抗癌活性，因此已证明具有可靠的临床益处。此外，联合疗法有望提供进一步的治疗可能性。LM治疗肺癌的临床研究已取得长足进展。然而，研究 LM 治疗肺癌的前瞻性临床试验的样本量仍然有限，大多数报告都是回顾性的。开发更有效的肺癌转移性 LM 管理方案仍然是未来的持续挑战。