Melanoma leptomeningeal disease: Advances in diagnosis and emerging therapeutic strategies

Table 1 Summary of survival outcomes in melanoma leptomeningeal disease cohorts

Ref.	n	Median OS	Treatment groups (summary)	Prognostic factors
Pedersen et al[11], 2025	67	8.4 months	ICI or BRAF/MEK improved OS; no OS difference between regimens	LMD independently worsens OS; ECOG ≥ 2, high LDH, male sex
Nyman et al[36], 2023	86	3.7 weeks untreated; 10.8 weeks treated	Systemic, intrathecal, or radiation therapy improved OS	Prior therapy; systemic treatment exposure
Chorti et al[8], 2021	52	2.9 months; 3.7 months with therapy	Modest OS benefit from targeted therapy or ICI	Elevated LDH; ECOG ≥ 2
Ferguson et al[19], 2019	178	3.5 months	Targeted and intrathecal therapy prolonged OS	Higher ECOG; neurologic symptoms; systemic disease protective
Tétu et al[21], 2020	29	5.1 months; 7.1 months with systemic + RT	Systemic + radiotherapy improved OS	High LDH; neurologic symptoms
Geukes Foppen et al[10], 2016	39	6.9 weeks; 2.9 untreated; 16.9 treated	Targeted therapy and immunotherapy improved OS	High LDH; high S100B
Harstad et al[121], 2008	110	10 weeks	Intrathecal chemotherapy associated with longer OS	High LDH; cytology not prognostic

OS: Overall survival; ICI: Immune checkpoint inhibitor; BRAF: B-rapidly accelerated fibrosarcoma; MEK: Mitogen-activated protein kinase; LMD: Leptomeningeal disease; ECOG: Eastern Cooperative Oncology Group; LDH: Lactate dehydrogenase; RT: Radiation therapy.