Blood-brain Barrier (BBB) Opening Using Exablate Focused Ultrasound With Standard of Care Treatment of NSCLC Brain Mets

This study tests whether using focused ultrasound to temporarily open the blood-brain barrier (a protective shield around the brain) can improve how well immunotherapy drugs reach brain metastases from non-small cell lung cancer (NSCLC). The blood-brain barrier normally blocks most cancer drugs from entering the brain. **You may be eligible if...** - You are 18 or older with non-small cell lung cancer (NSCLC) that has spread to the brain - You have been prescribed checkpoint inhibitor immunotherapy as part of your standard care - Your target brain lesion(s) are at least 0.5 cm in size - Your performance status is adequate (Karnofsky ≥70% or ECOG 0–2) **You may NOT be eligible if...** - You have a metallic implant in or near the skull that could interfere with the focused ultrasound device - You have severe blood clotting problems or are on anticoagulants that cannot be safely stopped - You have active serious infection or other conditions that make the procedure unsafe - You are pregnant Talk to your doctor to see if this trial is right for you.