Leptomeningeal metastasis from pancreatic cancer is rare and usually has a very short median survival of 1 to 2 months, but rare individual cases have lived longer with intensive treatment [1].
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Intrathecal therapy can shrink tumors and ease neurological symptoms in some patients with leptomeningeal metastasis, but benefits vary widely and it is not a cure.
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For EGFR-mutant lung cancer that has spread to the lining of the brain (leptomeningeal metastasis), studies point to osimertinib, sometimes combined with bevacizumab, and pemetrexed as treatments linked to longer survival.
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Intrathecal chemotherapy through an Ommaya reservoir is a standard way to treat leptomeningeal metastasis, and comparative evidence suggests it may improve disease control and survival versus repeated lumbar puncture [3][7].
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Intrathecal chemotherapy can shrink or stabilize leptomeningeal metastasis and may extend survival in some patients, but benefit varies by cancer type and the evidence is not uniform.
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