Alvocidib in Treating Patients With Metastatic or Unresectable Refractory Solid Tumors or Hematologic Malignancies

Inclusion Criteria: Histologically confirmed malignancy, including the following types: Hematologic malignancy, including any of the following: (Accrual for patients with hematologic malignancies temporarily closed as of 11/30/04) Mantle cell lymphoma Morphologically confirmed disease CD20 and CD5 positive Any other refractory lymphoma Chronic lymphocytic leukemia Rai stage III or IV and meeting at least 1 of the following criteria for active disease: Weight loss > 10% in the last 6 months Fatigue Fever or night sweats with no evidence of infection Progressive anemia or thrombocytopenia Progressive lymphocytosis with a lymphocyte doubling time of < 6 months Marked hypogammaglobulinemia or paraproteinemia Progressive splenomegaly and/or lymphadenopathy Multiple myeloma Disease confirmed by bone marrow aspirate and/or biopsy Relapsed or refractory disease after the most recent treatment regimen Quantifiable monoclonal immunoglobulin in serum and/or urine Solid tumor, including but not limited to any of the following: Breast cancer Histologically or cytologically confirmed stage IV invasive disease HER-2 positivity not required for study enrollment Tumor overexpressing HER-2 should be confirmed by immunohistochemistry OR fluorescence in situ hybridization Small cell lung cancer Extensive stage or limited stage disease in relapse Extrapulmonary small cell carcinoma allowed Squamous cell carcinoma of the head and neck Metastatic, recurrent, or refractory disease Renal cell carcinoma Mesothelioma Pleural or peritoneal disease of epithelial, sarcomatoid, or mixed subtype Melanoma Kaposi's sarcoma Metastatic or unresectable disease for which standard therapy does not exist or is no longer effective Measurable or nonmeasurable disease (solid tumor patients) Measurable disease defined as at least 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques or 10 mm by spiral CT scan Nonmeasurable disease includes any of the following: All other lesions, including lesions < 20 mm by conventional techniques or 10 mm by spiral CT scan Bone lesions Cytologically positive pleural or peritoneal disease Elevated tumor marker (e.g., CEA, CA 125, CA 19-9, or other tumor marker) Multinodular or confluent nonmeasurable pulmonary, hepatic, adrenal, intra-abdominal, or skin metastases Previously treated with at least 1 chemotherapy regimen* Prior therapy may have included combined modality treatment (e.g., full-dose chemotherapy and radiotherapy with radiosensitizing chemotherapy) Prior therapy with flavopiridol allowed provided the patient was enrolled in a flavopiridol clinical trial employing a different schedule NOTE: *Except in cases where chemotherapy is not known to be effective (e.g., renal cell carcinoma, chondrosarcoma, or gastrointestinal stromal tumor) No active CNS metastases History of CNS metastases allowed provided all of the following criteria are met: Previously treated and stable and asymptomatic for at least 4 weeks since the completion of treatment Image documentation required Off steroids or on a stable dose of steroids for at least 1 week Hormone receptor status: Not specified Age 18 and over Sex Male or female Menopausal status Not specified Performance status ECOG 0-1 OR Karnofsky 70-100% Life expectancy More than 12 weeks Hematopoietic Absolute neutrophil count > 1,000/mm^3* Platelet count > 75,000/mm^3 (50,000 for hematologic malignancies)* (Accrual for patients with hematologic malignancies temporarily closed as of 11/30/04) NOTE: *Unless abnormality is caused by tumor burden and not cumulative prior chemotherapy Hepatic Bilirubin normal AST/ALT ≤ 2.5 times upper limit of normal (ULN) (5 times ULN if liver metastases are present) Renal Creatinine ≤ 2.0 mg/dL OR Creatinine clearance ≥ 60 mL/min Cardiovascular No myocardial infarction within the past 6 months No unstable angina within the past 6 months No transient ischemic attack or cerebrovascular accident within the past 6 months No history of arterial vascular events No new cardiac arrhythmias likely to be related to cardiac ischemia within the past 6 months No symptomatic congestive heart failure Pulmonary No history of pulmonary embolism within the past 6 months Gastrointestinal No chronic diarrheal disease within the past 6 months No severe malnutrition No intractable emesis Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective hormonal or barrier contraception No ongoing or active infection No other concurrent uncontrolled illness No psychiatric illness or social situation that would preclude study compliance At least 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) At least 3 weeks since prior radiotherapy No prior radiotherapy to 50% or more of bone marrow Recovered from all prior therapy No other concurrent investigational agents No concurrent combination antiretroviral therapy for HIV-positive patients