Pemetrexed Disodium in the Cerebrospinal Fluid of Patients With Leptomeningeal Metastases

You may be eligible if

• DISEASE CHARACTERISTICS:
• Diagnosis of systemic malignancy (solid tumor or hematologic malignancy) or primary CNS lymphoma with leptomeningeal metastases (LM) as documented by MRI, cerebrospinal fluid, or both
• Patients may have brain metastases in addition to LM
• Patients with clinically significant interstitial fluid with effusion controlled by drainage are eligible
• PATIENT CHARACTERISTICS:
• Karnofsky performance status 60-100%
• Life expectancy \> 2 months
• Creatinine clearance ≥ 45 mL/min
• Bilirubin \< 1.5 times upper limit of normal (ULN)
• Transaminases \< 3.0 times ULN (5 times ULN for hepatic metastasis)
• WBC \> 3,000/mm³
• Neutrophil count \> 1,500/mm³
• Platelet count \> 100,000/mm³
• Hemoglobin \> 10 g/dL
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for 3 months after completion of study treatment
• Able to undergo lumbar puncture (i.e., no noncommunicating hydrocephalus or spinal block) or has an Ommaya reservoir in place
• Able to take steroids, cyanocobalamin (vitamin B12), and folic acid
• No other active cancer except nonmelanoma skin cancer or carcinoma in situ of the cervix
• Patients with prior malignancies who are in complete remission and are off all therapy for that malignancy for ≥ 3 years are eligible
• No significant medical or psychiatric illness that would interfere with study compliance
• PRIOR CONCURRENT THERAPY:
• More than 2 weeks since prior radiotherapy and recovered
• No concurrent radiotherapy
• No nonsteroidal anti-inflammatory drugs (NSAIDs) or acetylsalicylic acid within 2 days before or after study treatment (5 days for long-acting NSAIDs)
• No other concurrent cytotoxic chemotherapy
• Concurrent hormonal or biological therapy allowed