Temozolomide (TMZ) combined with cisplatin (CDDP) in patients with brain metastases from solid tumors: a Hellenic Cooperative Oncology Group (HeCOG) Phase II study

Purpose: To evaluate the efficacy of temozolomide (TMZ) combined with cisplatin (CDDP) in terms of response rate, time to progression (TTP) and overall survival (OS), as well as the tolerability of the regimen in patients with brain metastases from solid tumors. Patients and methods: Patients (n = 32) with brain metastases were treated with TMZ 150 mg/m(2)/day (chemotherapy-pretreated) or 200 mg/m(2)/day (chemotherapy-naive) for 5 days, combined with CDDP 75 mg/m(2) on day 1, every 28 days. Primary tumor sites included breast cancer (n = 15), lung cancer (n = 12) and other (n = 5). Twenty-seven patients had received prior chemotherapy for extracranial disease and 17 had prior radiotherapy to the brain. Results: One patient (3.1%) with non-small cell lung cancer (NSCLC) achieved complete response. Nine patients (28.1%; six with breast cancer, two with melanoma and one with NSCLC) achieved a partial response and five patients (16%) had stable disease. Median OS was 5.5 months and median TTP 2.9 months. One patient died from septicemia/neutropenic fever. Grade III-IV toxicities included anemia (9%), leukopenia (6%), thrombocytopenia (3%), renal toxicity (3%), headache (3%), fatigue (A), nausea (A), vomiting (A), and alopecia (6%). Conclusions: TMZ combined with CDDP is an active and well-tolerated combination in patients with brain metastases from solid tumors.