Medulloblastoma on the Move: How Tumor Cells Colonize the Leptomeninges – and How to Stop Them

Medulloblastoma is the most common malignant brain tumor in children. Patients who exhibit leptomeningeal metastasis – dissemination of tumor cells from the cerebellum to the membranes surrounding the brain and spinal cord – have particularly poor outcomes. Here we summarize our current understanding of the biology of leptomeningeal metastasis, including the route cells take to get to the leptomeninges and the signals that allow them to survive once they get there. We also examine emerging approaches to treatment, from targeted therapies and immunotherapies to strategies designed to bypass the blood-brain barrier. We conclude by highlighting vulnerabilities that may be exploited to improve outcomes for children with this disease.