Patient case: 46-year-old female with papillary thyroid carcinoma; genetic feature: NTRK1

Clinical trial: Combination Chemotherapy and Tamoxifen in Treating Patients With Solid Tumors

Summary: RATIONALE: Drugs used in chemotherapy, such as cisplatin and doxorubicin, work in different ways to stop tumor cells from dividing so they stop growing or die. Estrogen can stimulate the growth of tumor cells. Hormone therapy using tamoxifen may fight cancer by blocking the uptake of estrogen. Combining tamoxifen with chemotherapy may kill more tumor cells.
  PURPOSE: This phase II trial is studying how well giving cisplatin and doxorubicin together with tamoxifen works in treating patients with solid tumors.

Detailed description: OBJECTIVES:
  -  Determine the feasibility and efficacy of cisplatin, doxorubicin, and tamoxifen (CAT) in patients with soft tissue sarcoma, glioma, mesothelioma, hepatoma, thyroid cancer, or adrenal cancer.
  -  Determine the toxicity of this regimen in these patients.
  OUTLINE: Patients receive cisplatin IV over 1-2 hours followed immediately by doxorubicin IV over 15-30 minutes on days 1-3 and oral tamoxifen twice daily on days 4-17. Treatment continues every 3 weeks in the absence of the total cumulative doxorubicin dose reaching at least 500 mg/m2, disease progression, or unacceptable toxicity. Patients who achieve partial remission (PR) undergo local surgery or radiotherapy, if feasible, to convert PR to complete remission.
  Patients are followed every 2 months for 1 year and then every 3 months for 2 years.
  PROJECTED ACCRUAL: A total of 14-30 patients will be accrued for this study.

Eligibility: DISEASE CHARACTERISTICS:
  -  Histologically proven soft tissue sarcoma, glioma, mesothelioma, hepatoma, thyroid cancer, or adrenal cancer with clinical, radiological, or histologic evidence of incurability
  -  Patients with thyroid cancer must have failed radioactive iodine
  -  Measurable or evaluable disease
  PATIENT CHARACTERISTICS:
  Age:
  -  65 and under
  Performance status:
  -  ECOG 0-2
  Hematopoietic:
  -  Granulocyte count at least 1,500/mm3
  -  Platelet count at least 140,000/mm3
  Hepatic:
  -  Bilirubin normal
  Renal:
  -  Creatinine less than 1.47 mg/dL
  Cardiovascular:
  -  Left ventricular ejection fraction at least 50% by MUGA scan
  -  No congestive heart failure
  -  No severe, uncontrolled hypertension
  -  No ischemia, life-threatening arrhythmia, or conduction disturbance by ECG
  Other:
  -  No allergy to study medications
  -  No uncontrolled infection
  -  No active abuse of ethanol that would preclude treatment
  -  No other prior or concurrent malignancy
  -  Not pregnant
  -  Fertile patients must use effective contraception
  PRIOR CONCURRENT THERAPY:
  Biologic therapy:
  -  Not specified
  Chemotherapy:
  -  No more than 1 prior chemotherapy regimen
  -  No prior anthracycline or cisplatin
  -  At least 3 weeks since other prior chemotherapy and recovered
  Endocrine therapy:
  -  Not specified
  Radiotherapy:
  -  See Disease Characteristics
  -  No prior radiotherapy to more than 25% of bone marrow
  -  At least 3 weeks since other prior radiotherapy and recovered
  Surgery:
  -  Not specified

Relevance to patient case: not relevant