oxaliplatin with or without floxuridine and leucovorin in treating patients with metastatic cancer of the peritoneum

Conditions: Cancer

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. combining more than one drug may kill more tumor cells. purpose: phase i trial to study the effectiveness of oxaliplatin with or without floxuridine and leucovorin in treating patients who have metastatic cancer of the peritoneum.

objectives: * determine the maximum tolerated dose of intraperitoneal oxaliplatin with or without intraperitoneal floxuridine and leucovorin calcium in patients with metastatic cancer confined to the peritoneal cavity. * determine dose limiting and nondose limiting toxicities and pharmacokinetics of these treatment regimens in this patient population. outline: this is a dose escalation study of oxaliplatin. patients receive intraperitoneal (ip) oxaliplatin over 1 hour on day 1 every 2 weeks for 2 courses. beginning at course 3, patients receive oxaliplatin with floxuridine and leucovorin calcium ip on day 1 and floxuridine and leucovorin calcium ip alone on days 2 and 3. treatment repeats every 2 weeks in the absence of disease progression or unacceptable toxicity. patients with complete surgical resection of disease receive a total of 6 courses of combination chemotherapy. cohorts of 3-6 patients receive escalating doses of oxaliplatin until the maximum tolerated dose (mtd) is determined. the mtd is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose limiting toxicity. projected accrual: a total of 3-40 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * histologically or cytologically confirmed metastatic or unresectable cancer largely confined to the peritoneal cavity * fully resected and/or electrocauterized metastatic disease involving the peritoneum (stage iv, no residual disease) allowed * no known brain metastases patient characteristics: age: * 18 and over performance status: * ecog 0-2 life expectancy: * not specified hematopoietic: * wbc at least 3,000/mm\^3 * absolute neutrophil count at least 1,500/mm\^3 * platelet count at least 100,000/mm\^3 hepatic: * bilirubin normal * sgot/sgpt no greater than 2.5 times upper limit of normal renal: * creatinine normal or * creatinine clearance at least 60 ml/min cardiovascular: * no symptomatic congestive heart failure * no unstable angina pectoris * no cardiac arrhythmia other: * no history of allergy to platinum compounds or antiemetics that would preclude study * no other uncontrolled illness (e.g., active infection) * no evidence of neuropathy * not pregnant or nursing * negative pregnancy test * fertile patients must use effective contraception prior concurrent therapy: biologic therapy: * not specified chemotherapy: * at least 4 weeks since prior cytotoxic chemotherapy (6 weeks for mitomycin or nitrosoureas) and recovered endocrine therapy: * not specified radiotherapy: * at least 4 weeks since prior radiotherapy and recovered surgery: * see disease characteristics other: * no other concurrent investigational agents * no concurrent antiretroviral therapy (haart)

Keywords: stage iv colon cancer stage iv gastric cancer recurrent gastric cancer recurrent pancreatic cancer recurrent colon cancer regional neuroblastoma stage 4s neuroblastoma recurrent neuroblastoma regional gastrointestinal carcinoid tumor metastatic gastrointestinal carcinoid tumor recurrent gastrointestinal carcinoid tumor advanced adult primary liver cancer recurrent adult primary liver cancer gastrinoma small intestine adenocarcinoma small intestine lymphoma small intestine leiomyosarcoma unresectable gallbladder cancer recurrent gallbladder cancer unresectable extrahepatic bile duct cancer recurrent extrahepatic bile duct cancer recurrent small intestine cancer insulinoma recurrent islet cell carcinoma wdha syndrome somatostatinoma pancreatic polypeptide tumor glucagonoma regional pheochromocytoma metastatic pheochromocytoma recurrent pheochromocytoma extragonadal germ cell tumor liver metastases malignant ascites newly diagnosed carcinoma of unknown primary carcinoma of the appendix pseudomyxoma peritonei fallopian tube cancer primary peritoneal cavity cancer recurrent carcinoma of unknown primary gastrointestinal stromal tumor stage iv pancreatic cancer