Can a Direct-to-Brain chemo route outsmart resistant lung cancer?

This phase II trial is testing whether giving the chemotherapy drug thiotepa directly into the spinal fluid—via a small device called an Ommaya reservoir—can help control cancer that has spread to the lining of the brain and spinal cord (leptomeningeal metastases) in people with non-small cell lung cancer that no longer responds to EGFR-targeted therapy. The study will enroll about 50 adults aged 18 to 75. Participants receive thiotepa injections through the reservoir in a step-down schedule: twice a week for a month, then weekly for a month, then monthly for four months. The main goal is to see how well the treatment shrinks or controls cancer in the brain, and to check that it is safe to give this way.