TPDC-FUHU CHEMOTHERAPY FOR THE TREATMENT OF RECURRENT METASTATIC BRAIN-TUMORS

Purpose: To evaluate a combination of thioguanine, procarbazine, dibro modulcitol, CCNU (CCNU), fluorouracil, and hydroxyurea (TPDC-FuHu), de signed to improve the efficacy of CCNU, in the treatment of recurrent metastatic brain tumors.Patients and Methods: One hundred fifteen pati ents with progressive or recurrent metastatic brain rumors that failed to respond to surgery and/or radiation therapy were enrolled onto a m ulticenter prospective study between 1989 and 1995. Patients received TPDC-FuHu in a repeated cycle every 6 weeks until recurrence or until they completed six courses. Results: Ninety-seven patients were assess able at the end of the study. Forty-eight had lung cancer (39 nonsmall -cell [NSCLC] and nine small-cell [SCLC]), 28 had breast cancer, nine had melanoma, and 12 had adenocarcinoma of different origins (three co lon, two kidney, one bladder, one stomach, and five of unknown origin) . The response and stable disease (SD) rate (overall response rate) wa s 52%, 66%, 60%, and 22% in patients with NSCLC, SCLC, breast cancer, and melanoma, respectively. Median time to progression (MTP) was 12, 2 6, 12, and 6 weeks, respectively, for the four groups. Side effects we re mild to moderate in the majority of patients. Severe myelosuppressi on (grade 4) occurred in only 11% of the patients. Conclusion: TPDC-Fu Hu chemotherapy is an active treatment against recurrent brain metasta ses from breast cancer and SCLC, and to a lesser extent from NSCLC. Th is regimen is well tolerated and has acceptable toxicity. (C) 1997 by American Society of Clinical Oncology.