Electrochemotherapy as a Palliative Treatment for Brain Metastases

Inclusion Criteria:

* Patients \> 18 years.
* Performance status \< 2 (ECOG - Eastern Cooperative Oncology Group).
* Diagnosis of brain metastases originated from histological or cytological verified cancer of any histology.
* Patients should have received whole-brain radiation therapy (WBRT) with a time interval of at least 2 months from completion of WBRT until inclusion in this study.
* Patients must have been offered every available standard treatment.
* Brain metastases to be treated must have a diameter of at least 10 millimetres and no more than 27 millimetres.
* Brain metastases to be treated must be accessible for treatment.
* Estimated life expectancy must be more than 3 months.
* Patients must have adequate organ functions:

Adequate bone marrow reserve: Leucocytes (WBC) \> 3.0 x 109/l, thrombocytes \> 75 x 109/l, hemoglobin \> 7 g/dl.

Hepatic: Alkaline phosphate, ALAT or ASAT and bilirubin must not be increased more than 2 times, pp \> 40, APTT in normal range. Medical correction is allowed, e.g. correction of low pp using vitamin K.

Renal: if creatinin \> 150 micromolar do a GFR examination (Chrome-EDTA).

* Patients must not have a blood pressure (BP) over 180 mm Hg systolic and 110 mm Hg diastolic.
* Sexually active men and women of childbearing potential must use adequate birth control during this study and 6 month after the administration of bleomycin (contraceptive pills, intrauterine devices, injection of prolonged gestagen, subdermal implantation, hormonal vaginal devices, transdermal patches).
* Participating patients must be able to understand the patient information.
* Participating patients must have signed a written informed consent and power of attorney prior to inclusion in this study.

Exclusion Criteria:

* Acute lung infection.
* Previous bleomycin treatment with more than 200.000 IU/m2.
* Previous allergic reaction to bleomycin.
* Allergy towards the sedation used.
* Pregnancy or breastfeeding. Pregnancy in fertile women is excluded by a measurement of HCG in a blood sample. Sterile or infertile women are excluded from the requirement to use anticonception. To be considered sterile or infertile, the patient must have undergone surgical sterilization (vasectomy/bilateral tubectomy, hysterectomy and bilateral ovariectomy) or be post-menopausal defined as the absence of menstruation.
* Treatment with G-CSF (Granulocyte Colony Stimulating Factor) or other cytokines.
* Lung diffusion capacity (DLCO) below normal. DLCO is to be performed in case of suspected (anamnestic or clinical) reduced lung function.
* Physician's assessment that meningeal carcinomatosis (leptomeningeal disease) is a likely cause of the patient's symptoms.
* Treatment with anticoagulants (marevan, marcumar, innohep).
* Allergic to nickel, chrome or cobalt.
* Participation in another clinical study with an experimental drug up to 4 weeks prior to inclusion.
* Illnesses, medical, social or physiological, that may affect the patient's ability to understand the patient information and participate in the follow-up.
* Other serious systemic illnesses (i.e. active infection, abnormal EKG) that the investigator finds may affect the patient's safety and/or ability to complete the study.
* Treatment with Immunosuppressant drugs such as methotrexate and cyclosporine during the study. Treatment with prednisolone is accepted during the study.
* Implanted pacemaker, defibrillators or hearth valve prosthetics.
* Implanted devices such as neurostimulators, eartransplants, insulinpump, metallic tracheostomy.
* Catheters with metal such as Port á cath, Swan Ganz, P-dialysis cath., ventriculoatrial and -peritoneal shunts, bladder cath. with thermo-measurement.
* Metallic clips/prosthetics/magnets from surgery such as neuro- or abdominal clips, tooth- or other prosthetics.
* Disorganised metallic material such as metal fragments in the eyes, shrapnel, gun shot injuries.