• The maximum tolerable dose of temozolomide in combination with fixed dose of paclitaxel and carboplatin. The overall tumor response rate with this combination. [ Time Frame: Subjects will be followed in the clinic every four weeks to evaluate toxicity and tolerability. ] [ Designated as safety issue: Yes ]
  

• The duration of response. [ Time Frame: The treatment will continue until 1) intolerable toxicity, 2) a total of six cycles of treatments has been given, 3) documented progression of tumor, 4) subject withdraw from the study. ] [ Designated as safety issue: Yes ]
  

Drug: Combination Paclitaxel, Carboplatin and Temozolomide

Enrolled subjects will be receiving paclitaxel at dose of 175 mg/m2 and carboplatin at AUC of 5 on day 1 followed by starting dose of temozolomide at 75 mg/m2/day from day 2 to day 6, a total of 5 days for the first three subjects enrolled. Cycle length for the study is 21 days.

Subjects will be followed in the clinic every four weeks to evaluate toxicity and tolerability. The treatment will continue until 1) intolerable toxicity, 2) a total of six cycles of treatments has been given, 3) documented progression of tumor, 4) subject withdraw from the study.

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.