Breaking barriers in leptomeningeal disease: A Society for Neuro-Oncology and The American Society of Clinical Oncology consensus review on clinical trial design and basic science integration.

Leptomeningeal disease (LMD) is a devastating complication of cancer, and its incidence is rising. The inaugural LMD Think Tank Meeting took place in 2023 during the Society for Neuro-Oncology (SNO) and American Society of Clinical Oncology (ASCO) Central Nervous System (CNS) annual meeting, convening an international group of clinicians and scientists dedicated to understanding and treating LMD in a multidisciplinary fashion. While this meeting laid the foundation for a SNO/ASCO consensus review on the clinical management of LMD, the frequent exclusion of LMD patients from trials was identified as a clear and pervasive challenge. To address this gap, a follow-up assembly convened in 2024 with a goal of developing an SNO/ASCO consensus on best practices for clinical research; this included addressing the role of industry and basic scientists in clinical trials, providing guidance for improved clinical trial design, and accelerating the enrollment of LMD patients into clinical trials. Academic-industry partnerships and multi-institutional collaborations are crucial to advance our understanding of LMD, expand treatment access, and ultimately, improve survival and quality of life for our patients.