Docetaxel in Treating Children With Recurrent Solid Tumors

A PHASE II STUDY OF DOCETAXEL (TAXOTERE) (NSC# 628503) IN CHILDREN WITH RECURRENT SOLID TUMORS

Phase II trial to study the effectiveness of docetaxel in treating children with recurrent solid tumors. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die.

OBJECTIVES:

I. Determine the response rate to docetaxel in children with recurrent sarcomas, neuroblastomas, or brain tumors.

II. Describe the toxic effects of docetaxel in these patients.

OUTLINE:

All patients receive docetaxel with G-CSF every 21 days for up to 12 courses. Patients are followed for survival.

DISEASE CHARACTERISTICS:

• Histologically verified (at original diagnosis) solid tumor that is relapsed or refractory The following histologies are eligible:
• Sarcomas: Rhabdomyosarcoma Ewing's sarcoma, Peripheral neuroectodermal tumor (PNET), Osteosarcoma, Other soft tissue sarcomas
• Brain tumors: Ependymoma Primitive neuroectodermal tumor (PNET), High grade astrocytoma, Brain stem glioma (histologic verification not required), Neuroblastoma
• Measurable disease that can be followed clinically or radiologically required
• The following not considered measurable: Bone lesions measured by bone scan or bone marrow involvement
• Central nervous system disease documented by cerebrospinal fluid cytology
• Pleural effusion

PATIENT CHARACTERISTICS:

• Age: 21 and under at original diagnosis
• Performance status: 0-3
• Life expectancy: Greater than 2 months
• In the absence of marrow involvement:
• Absolute neutrophil count at least 1,000/mm3
• Platelet count at least 100,000/mm3 (transfusion independent)
• Hemoglobin at least 9.0 g/dL (transfusion allowed)
• With bone marrow involvement:
• Absolute neutrophil count at least 750/mm3
• Red cell and platelet support possible
• Bilirubin normal
• ALT/AST less than 1.5 times normal
• Alkaline phosphatase less than 2.5 times normal
• Creatinine no greater than 1.5 times normal OR creatinine clearance or radioisotope glomerular filtration rate at least 60 mL/min
• Not pregnant or nursing
• Adequate contraception required of fertile women

PRIOR CONCURRENT THERAPY:

• Prior bone marrow transplantation allowed:
• Must have stable engraftment without need for significant blood product support or cytokine therapy
• No concurrent immunomodulating agents
• No prior paclitaxel or docetaxel At least 2 weeks since chemotherapy (4 weeks since nitrosoureas)
• No other concurrent cancer chemotherapy
• Concurrent corticosteroids allowed for intracranial pressure in brain tumor patients provided patient has been stable for at least 4 weeks
• Corticosteroids allowed as pretreatment for docetaxel
• At least 2 months since extensive radiotherapy, defined as:
• Craniospinal Volume greater than 50% of abdominopelvic cavity
• Volume greater than one third of lung volume
• No concurrent radiotherapy
• No more than 2 prior therapies and fully recovered