Durable clinical benefit with exemestane in leptomeningeal metastasis of breast cancer

Since most chemotherapy agents do not cross the blood brain barrier, the classical approach for leptomeningeal metastasis (LM) of breast cancer is the administration of cranial intra-ventricular chemotherapy. The roles of hormonal agents like tamoxifen and aromatase inhibitors in LM treatment are not clear. We report the case of a patient with leptomeningeal metastasis from breast cancer with longterm stabilisation using exemestane. Although the ideal therapy for LM remains under dedate, hormonal therapy can contribute towards maintaining the response in some patients with LM and hormonepositive breast cancer.