Carboplatin and Temozolomide (Temodar) for Recurrent and Symptomatic Residual Brain Metastases

• Response rates of patients with MBT in comparison to historical controls treated with only RT [ Time Frame: Every 2 months ] [ Designated as safety issue: No ]
  

• Time to Progression analysis [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  
• Survival [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  
• CNS toxicity [ Time Frame: every cycle ] [ Designated as safety issue: Yes ]
  

Drug: carboplatin
IA carboplatin 200 mg/m2/day for each arterial injection on days 1 and 2.
Other Names:
• Paraplatin
• CBDCA
Drug: temozolomide
150 mg/m2/day orally Days 1-5. Treatment cycles to be repeated every 4 weeks.
Other Name: Temodar

Rationale: Surgery and radiation are often used as treatments for brain metastases, or tumors in the brain that originate from other parts of the body. It is currently unknown whether patient survival or time to progression would experience additional benefits through the addition of chemotherapy. Previous research does appear to suggest that a chemotherapy regimen may improve outcomes of patients with brain metastases previously treated with radiation. The current study further evaluates this research question by providing patients with recurrent or symptomatic residual brain metastases with carboplatin and temozolomide, two chemotherapy agents. Temozolomide has demonstrated clinical antitumor efficacy against malignant gliomas and has been tested with some efficacy against several other types of cancer. This drug appears to have less adverse effects compared to other commonly used cancer drugs. Recent research indicates that temozolomide also has some efficacy against brain metastases. In addition, previous research indicates carboplatin's lack of severe toxicity in patients with this disease.

Treatment: Study participants will be treated with carboplatin and temozolomide. Carboplatin will be administered through intravenous infusions. Temozolomide will be given through oral pills. Before these drugs are administered, study participants will undergo a pre-treatment evaluation with physical and neuropsychological examinations, neuro-imaging, laboratory tests, quality of life assessment, and other procedures. Carboplatin will be given for two consecutive days. Temozolomide will be taken by study participants daily for five consecutive days. Both of these treatment schedules will be repeated every 28 days. Several tests and exams will be given throughout the study to closely monitor patients. Study treatments will be discontinued due to disease growth or unacceptable adverse events.