Patient case: 45-year-old female with Meningioma. Genetic variant: NF2 (K322), AKT1(E17K). Other conditions: None.

Clinical trial: S9624 Ifosfamide in Treating Patients With Meningeal Tumors

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 ifosfamide in treating patients with meningeal tumors that have recurred or that cannot be removed surgically.

Detailed description: OBJECTIVES:
  -  Estimate failure free survival, overall survival, and response in patients with residual or recurrent/progressive aggressive meningeal tumors (malignant meningioma, hemangiopericytoma, and primary nervous system sarcoma) treated with ifosfamide.
  -  Evaluate toxicities of ifosfamide in this patient population.
  OUTLINE: All patients receive ifosfamide IV continuously over 72 hours on days 1-3 of each 21 day treatment course. Patients are evaluated for response/progression after every 2 courses. Patients with stable disease receive up to 8 courses of therapy. Treatment continues in the absence of disease progression or unacceptable toxicity.
  Patients are followed every 3 months for 1 year, then every 6 months thereafter.
  PROJECTED ACCRUAL: Approximately 35 patients will be accrued for this study.

Eligibility: DISEASE CHARACTERISTICS:
  -  Histologically proven recurrent or unresectable:
  -  Malignant meningioma
  -  Intracranial hemangiopericytoma
  -  Primary central nervous system sarcoma, including:
  -  Fibrosarcoma
  -  Rhabdomyosarcoma
  -  Chondrosarcoma
  -  Leiomyosarcoma
  -  Measurable or evaluable disease on CT or MRI scan
  -  Persistent disease following biopsy or incomplete resection OR
  -  Recurrent disease following complete resection
  -  No benign meningioma
  -  No prior or current systemic sarcoma
  PATIENT CHARACTERISTICS:
  Age:
  -  18 and over
  Performance status:
  -  SWOG 0-2
  Life expectancy:
  -  Not specified
  Hematopoietic:
  -  WBC at least 3,000/mm^3
  -  Absolute granulocyte count at least 1,500/mm^3
  -  Platelet count at least 100,000/mm^3
  Hepatic:
  -  Not specified
  Renal:
  -  Creatinine no greater than 2.0 mg/dL
  Cardiovascular:
  -  No myocardial infarction within the past 3 months
  -  No active angina
  -  No unstable heart rhythms
  -  No congestive heart failure
  Other:
  -  HIV negative
  -  No allergy to study drugs
  -  No serious concurrent medical or psychiatric illness
  -  No uncontrolled peptic ulcer disease
  -  No prior malignancy within past 5 years except adequately treated:
  -  Basal or squamous cell carcinoma of the skin
  -  Carcinoma in situ of the cervix
  -  Not pregnant or nursing
  -  Effective contraception required of fertile patients
  PRIOR CONCURRENT THERAPY:
  -  Recovered from toxic effects of prior therapy and/or from postoperative complications
  Biologic therapy:
  -  Not specified
  Chemotherapy:
  -  No prior ifosfamide
  -  No other concurrent chemotherapy
  Endocrine therapy:
  -  No concurrent hormonal therapy (except estrogen replacement therapy)
  -  Corticosteroids allowed if dose is stable or decreasing
  Radiotherapy:
  -  At least 4 weeks since prior radiotherapy
  -  Progressive disease following radiation required
  -  No concurrent radiotherapy
  Surgery:
  -  See Disease Characteristics

Relevance to patient case: not relevant