arsenic trioxide in treating patients with advanced neuroblastoma or other childhood solid tumors

Conditions: Brain and Central Nervous System Tumors; Childhood Germ Cell Tumor; Extragonadal Germ Cell Tumor; Kidney Cancer; Liver Cancer; Neuroblastoma; Ovarian Cancer; Retinoblastoma; Sarcoma

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. purpose: phase ii trial to study the effectiveness of arsenic trioxide in treating children who have advanced neuroblastoma or other solid tumors.

objectives: * determine the response rates of patients with advanced neuroblastoma or other pediatric solid tumors treated with arsenic trioxide. * determine the toxicity of this drug in these patients. outline: patients are stratified according to type of disease (neuroblastoma with progressive disease vs neuroblastoma with stable refractory disease vs other solid tumor). patients receive arsenic trioxide iv over 1-4 hours on days 1-5 and 8-12. treatment repeats every 28 days for a maximum of 6 courses in the absence of disease progression or unacceptable toxicity. patients are followed every 2-3 months for 1 year and then annually thereafter.

Eligibility criteria:
disease characteristics: * histologically confirmed neuroblastoma or other pediatric solid tumor (nonmyeloid and nonlymphoid) including the following: * ewing's family of tumors/primitive neuroectodermal tumor * retinoblastoma * nephroblastoma * osteosarcoma * rhabdomyosarcoma * desmoplastic small round-cell tumor * hepatoblastoma * germ cell tumors * medulloblastoma * relapsed from or resistant to prior standard anticancer therapy and/or no known standard therapy available * measurable disease (e.g., solid mass with definable dimensions) or * evaluable disease (e.g., bone marrow involvement or malignant pleural effusion) patient characteristics: age: * 40 and under performance status: * not specified life expectancy: * not specified hematopoietic: * not specified hepatic: * bilirubin no greater than 2.5 times upper limit of normal (uln) renal: * creatinine no greater than 2.5 times uln cardiovascular: * absolute qt interval no greater than 460 msec in the presence of adequate potassium and magnesium levels other: * no pre-existing neurotoxicity/neuropathy grade 2 or greater * no pre-existing convulsive disorder * no active serious infections uncontrolled by antibiotics * negative pregnancy test * fertile patients must use effective contraception prior concurrent therapy: biologic therapy: * not specified chemotherapy: * more than 3 weeks since prior cytotoxic chemotherapy * no other concurrent cytotoxic chemotherapy endocrine therapy: * not specified radiotherapy: * concurrent radiotherapy allowed provided measurable or evaluable disease exists outside radiation field surgery: * not specified other: * no other concurrent investigational agents

Keywords: metastatic osteosarcoma recurrent childhood rhabdomyosarcoma regional neuroblastoma disseminated neuroblastoma stage 4s neuroblastoma recurrent neuroblastoma stage iii childhood liver cancer stage iv childhood liver cancer recurrent childhood liver cancer childhood hepatoblastoma stage iii wilms tumor stage iv wilms tumor stage v wilms tumor recurrent wilms tumor and other childhood kidney tumors intraocular retinoblastoma extraocular retinoblastoma recurrent retinoblastoma recurrent osteosarcoma childhood germ cell tumor metastatic childhood soft tissue sarcoma recurrent childhood soft tissue sarcoma localized unresectable neuroblastoma previously untreated childhood rhabdomyosarcoma childhood desmoplastic small round cell tumor untreated childhood medulloblastoma recurrent childhood medulloblastoma previously treated childhood rhabdomyosarcoma metastatic ewing sarcoma/peripheral primitive neuroectodermal tumor recurrent ewing sarcoma/peripheral primitive neuroectodermal tumor childhood teratoma childhood malignant testicular germ cell tumor childhood malignant ovarian germ cell tumor childhood extragonadal germ cell tumor recurrent childhood malignant germ cell tumor