onconase plus doxorubicin versus doxorubicin alone for patients with malignant pleural or peritoneal mesothelioma who have had no more than one prior chemotherapy regimen

Conditions: Malignant Mesothelioma

Summary: rationale: drugs used in chemotherapy work in different ways to stop tumor cells from dividing so they stop growing or die. it is not yet known whether onconase plus doxorubicin is more effective than doxorubicin alone in treating patients with malignant mesothelioma. purpose: this randomized phase iii trial is studying doxorubicin alone to see how well it works compared to doxorubicin and onconase in treating patients with malignant mesothelioma.

objectives: * compare the efficacy of doxorubicin with or without ranpirnase in patients with malignant pleural or peritoneal mesothelioma. * compare the safety profile of these regimens in these patients. * compare the overall survival, progression-free survival, and quality of life of patients treated with these regimens. outline: this is a randomized, open-label, controlled, multicenter study. patients are stratified according to disease histology (epithelioid vs nonepithelioid) and calgb groups 1-4. patients are randomized to 1 of 2 treatment arms. * arm i: patients receive ranpirnase iv over 30 minutes weekly followed by doxorubicin iv. treatment repeats every 3 weeks for at least 6 courses in the absence of disease progression. patients demonstrating evidence of clinical response or stable disease may continue on maintenance therapy with ranpirnase as a single agent until disease progression. * arm ii: patients receive doxorubicin as in arm i for up to 6 courses. quality of life is assessed. projected accrual: a minimum of 300 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * histologically confirmed malignant pleural or peritoneal mesothelioma * measurable or evaluable disease * calgb groups 1-4 * no cns metastases patient characteristics: age: * 21 and over performance status: * ecog 0-1 life expectancy: * not specified hematopoietic: * wbc greater than 3,500/mm\^3 * absolute neutrophil count at least 1,500/mm\^3 * platelet count at least 100,000/mm\^3 hepatic: * sgot no greater than 2 times upper limit of normal * bilirubin no greater than 2 mg/dl * pt and ptt normal renal: * creatinine normal cardiovascular: * no symptomatic new york heart association class ii-iv cardiovascular disease * no congestive heart failure * no angina pectoris * no cardiac arrhythmias * no uncontrolled hypertension * no cerebrovascular disease metabolic: * no serum calcium, phosphate, electrolyte, or other metabolic abnormalities, such as metabolic acidosis other: * not pregnant or nursing * negative pregnancy test * fertile patients must use effective contraception * no serious infection * no uncontrolled psychosis or neurologic disease (e.g., seizure disorders) * no uncontrolled diabetes mellitus * no other primary malignancy within the past 5 years except nonmelanoma skin cancer * no senility or emotional instability prior concurrent therapy: biologic therapy: * not specified chemotherapy: * no more than one prior systemic chemotherapy regimen * no prior doxorubicin * at least 6 weeks since prior chemotherapy endocrine therapy: * not specified radiotherapy: * prior radiotherapy for progressive or recurrent disease allowed except myocardium radiotherapy surgery: * prior surgical resection allowed

Keywords: localized malignant mesothelioma advanced malignant mesothelioma recurrent malignant mesothelioma