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This article talks about leptomeningeal spread. (Which means the tumor spreads to the lining of the brain and spinal cord). The common wisdom used to be that once this happened, the outlook was terrible and it wasn't worth even trying to treat it. This article (and other experiences such as from MD Anderson (https://www.mdanderson.org/publications/cancerwise/new-hope-for-leptomeningeal-disease-care.h00-159144456.html) show that it IS worth trying to treat it, and the outlook is only about as bad as the usual recurrences that do not involve the meninges. Many clinical trials and even compassionate use programs exclude patients with leptomeningeal spread. They shouldn't.