Patient case: 49-year-old female with Gastrointestinal stromal tumor. Genetic variant: KIT Exon 9 (A502_Y503dup). Other conditions: None.

Clinical trial: Brostallicin in Treating Patients With Locally Advanced or Metastatic Soft Tissue 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 brostallicin in treating patients who have locally advanced or metastatic soft tissue sarcoma that has not responded to one previous chemotherapy regimen.

Detailed description: OBJECTIVES:
  -  Determine the antitumor activity of brostallicin, in terms of objective response, in patients with locally advanced or metastatic soft tissue sarcoma who have failed one prior chemotherapy treatment.
  -  Determine the time to progression and duration of response in patients treated with this drug.
  -  Determine the safety and toxic effects of this drug in these patients.
  -  Correlate clinical outcome with whole blood glutathione level in patients treated with this drug.
  OUTLINE: This is a multicenter study. Patients are stratified according to tumor (tumors other than gastrointestinal stromal tumor (GIST) vs GIST).
  Patients receive brostallicin IV over 10 minutes on day 1. Treatment repeats every 21 days for at least 4 courses in the absence of disease progression or unacceptable toxicity.
  Patients are followed every 2 months for 1 year and then every 4 months for 1 year.
  PROJECTED ACCRUAL: A total of 58-72 patients (40 for stratum I and 18-32 for stratum II) will be accrued for this study.

Eligibility: DISEASE CHARACTERISTICS:
  -  Histologically confirmed soft tissue sarcoma that is not amenable to surgery, radiotherapy, or combined modality therapy with curative intent
  -  Stratum I
  -  Malignant fibrous histiocytoma
  -  Liposarcoma
  -  Rhabdomyosarcoma
  -  Synovial sarcoma
  -  Malignant paraganglioma
  -  Fibrosarcoma
  -  Leiomyosarcoma
  -  Angiosarcoma including hemangiopericytoma
  -  Malignant peripheral nerve sheath tumor
  -  Unclassified sarcoma
  -  Miscellaneous sarcoma
  -  Stratum II
  -  Gastrointestinal stromal tumor
  -  Previously treated with imatinib mesylate for locally advanced or metastatic disease and demonstrated disease progression
  -  The following sarcoma types are excluded:
  -  Mixed mesodermal tumors of the uterus (and carcinosarcoma)
  -  Chondrosarcoma
  -  Malignant mesothelioma
  -  Neuroblastoma
  -  Osteosarcoma
  -  Ewing's sarcoma
  -  Embryonal rhabdomyosarcoma
  -  At least one measurable lesion
  -  Progressive disease after 1 prior anthracycline- and/or alkylating-containing chemotherapy regimen for locally advanced or metastatic disease
  -  Clinical evidence of progression within 6 weeks prior to study treatment
  -  No known or symptomatic CNS metastases
  PATIENT CHARACTERISTICS:
  Age:
  -  Over 15
  Performance status:
  -  WHO 0-1
  Life expectancy:
  -  Not specified
  Hematopoietic:
  -  WBC at least 4,000/mm^3
  -  Platelet count at least 100,000/mm^3
  Hepatic:
  -  Bilirubin no greater than 1.25 times upper limit of normal (ULN)
  -  SGPT and SGOT no greater than 3 times ULN
  -  Alkaline phosphatase no greater than 2.5 times ULN
  Renal:
  -  Creatinine no greater than 1.4 mg/dL OR
  -  Creatinine clearance greater than 65 mL/min
  Cardiovascular:
  -  No prior severe cardiovascular disease
  Other:
  -  Not pregnant
  -  Negative pregnancy test
  -  Fertile patients must use effective contraception during and for up to 6 months after study
  -  No other prior or concurrent malignancy except adequately treated basal cell skin cancer or carcinoma in situ of the cervix
  -  No other severe medical illness
  -  No psychosis
  PRIOR CONCURRENT THERAPY:
  Biologic therapy:
  -  No concurrent biologic response modifiers or immunotherapy
  -  No concurrent prophylactic hematopoietic growth factors (e.g., filgrastim (G- CSF) or sargramostim (GM-CSF)
  Chemotherapy:
  -  See Disease Characteristics
  -  More than 4 weeks since prior chemotherapy and recovered
  -  Prior adjuvant chemotherapy as first-line treatment allowed provided disease progressed within 6 months after the completion of chemotherapy
  -  No prior ecteinascidin 743 (stratum I)
  -  No other concurrent chemotherapy
  Endocrine therapy:
  -  No concurrent hormonal therapy
  Radiotherapy:
  -  See Disease Characteristics
  -  Recovered from prior radiotherapy
  -  No prior radiotherapy to sole measurable lesion
  -  Concurrent palliative radiotherapy to nontarget lesions allowed at investigator's discretion
  Surgery:
  -  See Disease Characteristics
  -  Recovered from prior surgery
  Other:
  -  No other concurrent anticancer therapy (approved or investigational)
  -  No concurrent participation in any other clinical treatment study
  -  No other concurrent investigational drugs

Relevance to patient case: not relevant