irinotecan in treating patients with solid tumors or lymphoma who have abnormal liver or kidney function or who have received radiation therapy to the pelvis

Conditions: Lymphoma; Small Intestine Cancer; Unspecified Adult Solid Tumor, Protocol Specific

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. irinotecan may be effective in treating patients with abnormal liver or kidney function or who have received radiation therapy. purpose: phase i trial to study the effectiveness of irinotecan in treating patients with solid tumors or lymphoma who have abnormal liver or kidney function or who have had previous radiation therapy to the pelvis.

objectives: i. determine the maximum tolerated dose of irinotecan in patients with solid tumors or lymphoma who have liver or renal dysfunction or have had prior pelvic radiation. ii. characterize the pharmacokinetics of irinotecan in these patients. outline: this is a dose escalation study. patients are stratified according to prior pelvic radiation therapy (yes vs no). patients with no prior pelvic radiation are further stratified according to ast, bilirubin, and creatinine levels. patients receive irinotecan iv over 90 minutes every 3 weeks for a total of 2 courses. after patients are reevaluated, treatment may continue in the absence of disease progression or unacceptable toxicity. cohorts of 3 to 6 patients receive escalating doses of irinotecan. dose escalation proceeds within each stratum until the maximum tolerated dose (mtd) is determined. the mtd is defined as the dose below that at which 2 of 6 patients experience dose-limiting toxicity. projected accrual: approximately 75 patients will be accrued for this study at a rate of 2-3 patients per month.

Eligibility criteria:
disease characteristics: histologically proven solid tumors or lymphoma refractory to standard therapy or for which no standard therapy exists brain metastases allowed if following criteria met: asymptomatic received prior therapy for brain metastases stable for at least 2 months no concurrent steroid therapy patient characteristics: age: 18 and over performance status: calgb 0-2 life expectancy: not specified hematopoietic: granulocyte count at least 1,500/mm3 platelet count at least 100,000/mm3 hepatic and renal: albumin at least 2.5 g/dl prothrombin time less than 1.6 for patients without prior pelvic radiotherapy: ast at least 3 times upper limit of normal (uln) or bilirubin 1.0 - 7.0 mg/dl with any ast or creatinine 1.6 - 5.0 mg/dl for patients with prior pelvic radiotherapy: ast less than 3 times uln and bilirubin less than 1.0 mg/dl and creatinine less than 1.6 mg/dl other: not pregnant or nursing prior concurrent therapy: biologic therapy: no concurrent colony stimulating factors chemotherapy: at least 4 weeks since prior chemotherapy (at least 6 weeks since melphalan or mitomycin) at least 3 months since suramin no prior nitrosoureas or irinotecan endocrine therapy: no concurrent steroids (except as antiemetic for chemotherapy) radiotherapy: at least 4 weeks since prior radiotherapy surgery: at least 4 weeks since major surgery other: no concurrent medications known to affect hepatic or renal function (e.g., antiseizure medication or nonsteroidal antiinflammatory drugs)

Keywords: stage iii adult hodgkin lymphoma stage iv adult hodgkin lymphoma recurrent adult hodgkin lymphoma stage iii cutaneous t-cell non-hodgkin lymphoma stage iv cutaneous t-cell non-hodgkin lymphoma recurrent cutaneous t-cell non-hodgkin lymphoma small intestine lymphoma unspecified adult solid tumor, protocol specific stage iii grade 1 follicular lymphoma stage iii grade 2 follicular lymphoma stage iii grade 3 follicular lymphoma stage iii adult diffuse small cleaved cell lymphoma stage iii adult diffuse mixed cell lymphoma stage iii adult diffuse large cell lymphoma stage iii adult immunoblastic large cell lymphoma stage iii adult lymphoblastic lymphoma stage iii adult burkitt lymphoma stage iv grade 1 follicular lymphoma stage iv grade 2 follicular lymphoma stage iv grade 3 follicular lymphoma stage iv adult diffuse small cleaved cell lymphoma stage iv adult diffuse mixed cell lymphoma stage iv adult diffuse large cell lymphoma stage iv adult immunoblastic large cell lymphoma stage iv adult lymphoblastic lymphoma stage iv adult burkitt lymphoma recurrent grade 1 follicular lymphoma recurrent grade 2 follicular lymphoma recurrent grade 3 follicular lymphoma recurrent adult diffuse small cleaved cell lymphoma recurrent adult diffuse mixed cell lymphoma recurrent adult diffuse large cell lymphoma recurrent adult immunoblastic large cell lymphoma recurrent adult lymphoblastic lymphoma recurrent adult burkitt lymphoma stage iii adult t-cell leukemia/lymphoma stage iv adult t-cell leukemia/lymphoma recurrent adult t-cell leukemia/lymphoma primary central nervous system non-hodgkin lymphoma aids-related peripheral/systemic lymphoma aids-related primary cns lymphoma intraocular lymphoma stage iii mantle cell lymphoma stage iv mantle cell lymphoma recurrent mantle cell lymphoma angioimmunoblastic t-cell lymphoma anaplastic large cell lymphoma stage iii mycosis fungoides/sezary syndrome stage iv mycosis fungoides/sezary syndrome recurrent mycosis fungoides/sezary syndrome recurrent marginal zone lymphoma recurrent small lymphocytic lymphoma stage iii small lymphocytic lymphoma stage iii marginal zone lymphoma stage iv small lymphocytic lymphoma stage iv marginal zone lymphoma extranodal marginal zone b-cell lymphoma of mucosa-associated lymphoid tissue nodal marginal zone b-cell lymphoma splenic marginal zone lymphoma