{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:04:29Z","timestamp":1791821069989,"version":"4.3.4"},"reference-count":23,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,5,29]]},"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>Leptomeningeal disease is rare in pancreatic cancer and prognosis remains poor. Mutation profiles are now directing therapy to improve survival. We describe a case of leptomeningeal and brain metastasis in BRCA1 interacting protein 1, or BRIP1-mutated pancreatic adenocarcinoma with progression through several lines of chemotherapy and immunotherapy. A woman in her late 50s presented with metastatic pancreatic adenocarcinoma on liver biopsy. She achieved complete response after modified FOLFIRINOX and started a poly (ADP-ribose) polymerase (PARP) inhibitor for a BRIP1 mutation. She had recurrence at 9 months and started pembrolizumab (programmed cell death protein 1, or PD-1receptor antibody) for tumour mutational burden of 10 muts\/Mb. At 10 months, she presented with lower extremity weakness and back pain. MRI revealed leptomeningeal metastases from T11 to cauda equina roots and right occipital metastasis. Cerebrospinal fluid studies revealed elevated pressure (290\u2009mm H<jats:sub>2<\/jats:sub>O) and protein (73\u2009mg\/dL) with negative cytology. Leptomeningeal carcinomatosis was diagnosed. She began palliative radiation but died at 11 months from initial diagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2022-249837","type":"journal-article","created":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T11:06:13Z","timestamp":1654686373000},"page":"e249837","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Leptomeningeal disease in BRIP1-mutated pancreatic adenocarcinoma"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1726-9706","authenticated-orcid":false,"given":"Eunji","family":"Yim","sequence":"first","affiliation":[{"name":"Neurology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Leung","sequence":"additional","affiliation":[{"name":"Neurology, University of Michigan, Ann Arbor, Michigan, 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