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We aim to determine if modern systemic therapy, especially the bevacizumab, cisplatin, and etoposide (BEEP) regimen, is beneficial to MBC LM patients.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We excerpted data from a prospectively collected cytopathology database for MBC patients who were diagnosed with LM by positive cerebrospinal fluid cytology. The primary outcome was OS from cytologically confirmed LM until death. Univariate and multivariate analyses were performed to elucidate prognostic factors.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>We identified 34 patients with cytologically confirmed LM. Treatments after LM diagnosis included: intrathecal methotrexate (82.4%), systemic chemotherapy (68%; BEEP n\u2009=\u200919, others n\u2009=\u20094), and whole brain radiotherapy (n\u2009=\u20095, 14.7%). Three of seven HER2-positive patients (43%) also received intrathecal trastuzumab. OS was improved in 2014\u20132016 compared with 2011\u20132013 (13.57 vs 3.20\u00a0months, p\u2009=\u20090.004), when 12\/17 (71%) versus 7\/17 (41%) patients received BEEP, respectively. In the multivariate model including all treatments, BEEP (HR 0.24, p\u2009=\u20090.003) and intrathecal trastuzumab (HR 0.22, p\u2009=\u20090.035), but not intrathecal methotrexate (HR 0.86, p\u2009=\u20090.78), remained significant prognostic factors.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>MBC with LM is treatable\u2014systemic BEEP are efficacious and may improve survival.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s11060-020-03510-y","type":"journal-article","created":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T00:02:36Z","timestamp":1588118556000},"page":"165-172","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Systemic treatment of breast cancer with leptomeningeal metastases using bevacizumab, etoposide and cisplatin (BEEP regimen) significantly improves overall survival"],"prefix":"10.1007","volume":"148","author":[{"given":"Tom Wei-Wu","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I-Shiow","family":"Jan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dwang-Ying","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching-Hung","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I-Chun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ho-Min","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann-Lii","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7461-1291","authenticated-orcid":false,"given":"Yen-Shen","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,4,29]]},"reference":[{"issue":"suppl_4","key":"3510_CR1","doi-asserted-by":"publisher","first-page":"iv84","DOI":"10.1093\/annonc\/mdx221","volume":"28","author":"E Le Rhun","year":"2017","unstructured":"Le Rhun E, Weller M, Brandsma D, VandenBent M, de Azambuja E, Henriksson R, Boulanger T, Peters S, Watts C, Wick W, Wesseling P, Ruda R, Preusser M, Board EE, Committee EG (2017) EANO-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with leptomeningeal metastasis from solid tumours. 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YSL reports clinical trial study fee from Novartis, Roche, Merck Sharp & Dohme, Pfizer, and GlaxoSmithKline; personal fees from Novartis, Pfizer, Boehringer Ingelheim, and Eisai for consultant fee and honorarium. ALC reports clinical trial study fee and honorarium from Roche. All other authors have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The NTUH Research Ethics Committee approved the study under a blanket protocol (201003025R) for analysis of medical data from patients with stage IV breast cancer. Informed consent from the patients was waived for retrospective medical record review studies per the protocol of the NTUH Research Ethics Committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}