Taxotere, Cisplatin and Irinotecan (CPT-11) for Esophagogastric Cancer

This is a phase II study of taxotere, cisplatin and irinotecan (CPT-11) used in combination to treat metastatic esophageal and gastric cancer in an effort to see what effects (good and bad) the combination may have on the patients cancer.

* Taxotere, cisplatin and irinotecan will be administered to the patient once weekly for 2 weeks followed by a one week rest period (1 cycle is 3 weeks).
* Patients will also receive corticosteroids, intravenous hydration and anti-emetic therapy prior to each treatment.
* A physical exam and bloodwork will be done each week of the treatment and every 2 cycles, reassessment of the tumor by the same imaging method to determine the baseline size will be conducted.
* Patients will remain on the study unless disease progression or intolerable toxicity occur.

Eligibility Criteria:
Inclusion Criteria:

* Histologically confirmed, incurable esophageal or gastric carcinoma (carcinoma = adenocarcinoma or squamous cell carcinoma)
* Measurable disease \> 1cm (longest diameter) by spiral CT scan or \> 2cm by other radiographic technique.
* Lesions must be measurable in at least one dimension.
* Bone lesions, ascites and effusions are not measurable.
* Irradiated lesions are not measurable yet lesions arising in previously irradiated fields are measurable.
* Age 18+ years.
* ECOG performance status 0 or 1.
* Life expectancy greater than 12 weeks.
* Adequate bone marrow function.
* Adequate renal function: creatinine equal to or less than 1.5 mg/dl.
* SGOT less than 2.5 x institutional upper limit of normal if alkaline phosphatase is within institutional upper limit of normal.
* Alkaline phosphatase less than 4.0 x upper limit of normal if SGOT is within institutional upper limit of normal.
* For patients with both SGOT and alkaline phosphatase elevations, SGOT must be less than 1.5 x institutional upper limit of normal and alkaline phosphatase must be less 2.5 x institutional upper limit of normal. For patients with liver metastases, however, SGOT may be \< 3.0 x institutional upper limit of normal and alkaline phosphatase may be \< 5.0 x institutional upper limit of normal as long as the total bilirubin is within the institutional upper limit of normal.

Exclusion Criteria:

* No prior chemotherapy (except as part of pre- or post-operative therapy, completed \> 1 year prior to start date of this protocol).
* Patients who have received prior pelvic radiation therapy are ineligible. Other prior radiation therapy, however, is permitted, provided at least 4 weeks have elapsed since completion of this therapy and the initiation of this protocol.
* No myocardial infarction in the past six months.
* No major surgery in the past three weeks.
* No uncontrolled serious medical or psychiatric illness.
* No uncontrolled diarrhea.
* Patients with a peripheral neuropathy \> grade 1 will be excluded.
* Women of childbearing potential must have a negative pregnancy test. Men and women of childbearing potential must use adequate contraception.
* No clinically apparent central nervous system metastases or carcinomatous meningitis.
* No other active malignancy other than non-melanoma skin cancer or in-situ cervical carcinoma. A resected cancer (other than in-situ carcinoma) must have demonstrated no evidence of recurrence for at least 3 years.
* Patients with history of severe hypersensitivity to irinotecan, cisplatin, taxotere or drugs formulated with polysorbate 80 must be excluded.