Patient case: 54-year-old male with malignant hyperthermia; genetic feature: RYR1

Clinical trial: Whole Body Hyperthermia Combined With Chemotherapy in Treating Patients With Metastatic Breast, Ovarian, Endometrial, or Cervical Cancer

Summary: RATIONALE: Hyperthermia therapy kills tumor cells by heating them to several degrees above body temperature. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining chemotherapy with hyperthermia may kill more tumor cells.
  PURPOSE: This phase II trial is studying how well giving fluorouracil and liposomal doxorubicin together with systemic hyperthermia works in treating patients with metastatic breast, ovarian, endometrial, or cervical cancer.

Detailed description: OBJECTIVES:
  -  Evaluate tumor response and toxicity induced by fluorouracil and doxorubicin HCl liposome combined with mild systemic hyperthermia in patients with metastatic breast, ovarian, endometrial, or cervical cancer.
  OUTLINE: This is a time-escalation study of systemic hyperthermia.
  Patients receive fluorouracil IV continuously over 24 hours on days 1-5 and doxorubicin HCl liposome IV over 30 minutes on day 6. Beginning on day 7, patients receive heat applied for 6-24 hours (in 6-hour sequential treatments) using a mild hyperthermia-induction device. Treatment repeats every 4-5 weeks for a total of 4 courses. Patients who achieve less than a complete response but have no disease progression may receive additional courses of chemotherapy alone.
  Cohorts of 5 patients receive escalating durations of hyperthermia until the recommended phase II duration is determined. The recommended phase II duration of hyperthermia is defined as the level preceding that at which 1 of 5 patients experiences measurable toxicity. (Phase I closed as of 9/28/01)
  Patients are followed at 4 weeks and then every 6 months for 1 year.
  PROJECTED ACCRUAL: A maximum of 34 patients will be accrued for this study within 48 months.

Eligibility: DISEASE CHARACTERISTICS:
  -  Histologically confirmed metastatic breast, ovarian, endometrial, or cervical carcinoma
  -  Measurable and evaluable disease
  -  No brain metastases
  -  No hepatic involvement greater than 80%
  -  No lung involvement greater than 30%
  -  Hormone receptor status:
  -  Not specified
  PATIENT CHARACTERISTICS:
  Age:
  -  18 and over
  Sex:
  -  Not specified
  Menopausal status:
  -  Not specified
  Performance status:
  -  Zubrod 0-2
  Life expectancy:
  -  At least 12 weeks
  Hematopoietic:
  -  Absolute granulocyte count greater than 1,500/mm^3
  -  Platelet count greater than 90,000/mm^3
  -  Normal bone marrow cellularity on bone marrow biopsy
  -  Thrombin time less than 17 sec
  -  Fibrinogen greater than 200 mg/dL
  -  FSP less than 40
  -  No coagulopathy
  Hepatic:
  -  Bilirubin less than 2.0 mg/dL
  -  SGPT less than 2 times normal
  -  PT less than 14 sec
  -  PTT less than 35 sec
  Renal:
  -  BUN less than 25 mg/dL
  -  Creatinine clearance at least 45 mL/min
  Cardiovascular:
  -  Normal cardiovascular system
  -  Resting ventricular ejection fraction greater than 40%
  -  No prior myocardial infarction
  -  No symptomatic coronary artery disease
  -  No unstable blood pressure
  -  No thromboembolic disease
  Neurologic:
  -  No seizures or other CNS disorders
  -  Negative computerized tomographic scan of brain
  Pulmonary:
  -  FEV_1 greater than 70% of predicted
  -  Arterial pressure of oxygen greater than 60 mmHg on room air with appropriate pressure of carbon dioxide and pH values
  -  No history of cardiopulmonary or respiratory disease
  Other:
  -  No other serious concurrent medical illness
  -  No diabetes mellitus
  PRIOR CONCURRENT THERAPY:
  Biologic therapy:
  -  Not specified
  Chemotherapy:
  -  Prior chemotherapy allowed
  Endocrine therapy:
  -  No adrenal corticosteroids
  Radiotherapy:
  -  Not specified
  Surgery:
  -  Not specified
  Other:
  -  No concurrent cardiac glycosides, antianginal therapy, or antiarrhythmics
  -  No concurrent vasodilators, anticoagulants, thrombolytic agents, or aspirin

Relevance to patient case: not relevant