Leptomeningeal metastasis (LM) is associated with poor prognoses. In this interview, Gaia Griguolo, MD, University of Padova, Padova, Italy, details the Response Assessment in Neuro-Oncology (RANO) LM working group which proposed a standardized scorecard to aid in the evaluation of MRI findings in LM. The 2019 RANO revised response score was associated with overall survival (OS) in patients with LM from breast cancer, thus validating these criteria in a real-world cohort. This interview took place at the San Antonio Breast Cancer Symposium 2021 in San Antonio.