How would you treat a metastatic pancreatic cancer patient who develops symptomatic leptomeningeal disease on first line FOLFIRINOX?

This is a really unfortunate situation. There is some evidence that gemcitabine, at least, crosses the blood-brain barrier and there is at least one case report of a patient in a similar situation responding to gemcitabine/nab-paclitaxel. Given this and the paucity of data supporting other options f...