Combination Paclitaxel, Carboplatin and Temozolomide

The objective of the research study is to test a combination of drugs to treat small cell
lung cancer which has spread beyond the lungs (extensive cancer) or come back after earlier
treatment (recurrent cancer).

Inclusion Criteria:

1. Age greater than or equal to 18 years

2. Karnofsky performance status (KPS) of greater than or equal to 70 (Appendix B)

3. Laboratory values (performed within 14 days prior to study drug administration,
inclusive).

1. Absolute neutrophil count (ANC) >1500/mm3

2. Platelet count >100,000/mm3

3. Hemoglobin >10 g/dl or 100 g/l

4. BUN and serum creatinine <1.5 times upper limit of laboratory normal

5. Total and direct bilirubin <1.5 times upper limit of laboratory normal

6. SGOT and SGPT <3 times upper limit of laboratory normal

7. Alkaline Phosphatase <3 times upper limit of laboratory normal

4. A life expectancy of greater than 12 weeks

5. Subjects must give written informed consent.

6. Biopsy proven small cell lung cancer.

7. CT of chest, abdomen, pelvis and MRI of head

8. Patients with brain metastases should be asymptomatic to enter the study

Exclusion Criteria:

1. No recovery from all active toxicities of prior therapies.

2. Subjects who are poor medical risks because of non-malignant systemic disease as well
as those with acute infection treated with intravenous antibiotics.

3. Frequent vomiting or medical condition that could interfere with oral medication
intake (eg, partial bowel obstruction).

4. Concurrent malignancies at other sites with the exception of surgically cured
carcinoma in-site of the cervix and basal or squamous cell carcinoma of the skin.
Prior malignancies which have not required anti-tumor treatment within the preceding
24 months are eligible.

5. Known HIV positivity or AIDS-related illness.

6. Pregnant or nursing women.

7. Women of childbearing potential who are not using an effective method of
contraception. Women of childbearing potential must have a negative serum pregnancy
test 24 hours prior to administration of study drug and be practicing medically
approved contraceptive precautions.

8. Men who are not advised to use an effective method of contraception.

9. Progression of disease on prior chemotherapy with paclitaxel and carboplatin, either
as single agent or in combination.

10. Known hypersensitivity reaction to taxoid or platinum compound.