Brostallicin or Doxorubicin as First-Line Therapy in Treating Patients With Relapsed, Refractory, or Metastatic Soft Tissue Sarcoma

This is an interventional treatment trial for Ovarian Cancer focused on measuring recurrent adult soft tissue sarcoma, stage IV adult soft tissue sarcoma, adult liposarcoma, adult fibrosarcoma, adult malignant fibrous histiocytoma, adult leiomyosarcoma, adult rhabdomyosarcoma, adult alveolar soft-part sarcoma, adult malignant mesenchymoma, adult angiosarcoma, adult epithelioid sarcoma, adult neurofibrosarcoma, adult synovial sarcoma, recurrent uterine sarcoma, stage IV uterine sarcoma, ovarian sarcoma, small intestine leiomyosarcoma, recurrent small intestine cancer Read More

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed high- or intermediate-grade malignant soft tissue sarcoma* of 1 of the following cellular types:

  • Adipocytic (e.g., liposarcoma dedifferentiated, myxoid/round cell, pleomorphic, mixed-type, not otherwise specified)
  • Fibroblastic (e.g., adult fibrosarcoma, myxofibrosarcoma, or sclerosing epithelioid fibrosarcoma)
  • So-called fibrohistiocytic (e.g., pleomorphic malignant fibrous histiocytoma [MFH], giant cell MFH, or inflammatory MFH)
  • Leiomyosarcoma
  • Malignant glomus tumors
  • Skeletal muscle (e.g., rhabdomyosarcoma, alveolar, or pleomorphic)
  • Vascular (e.g., epithelioid hemangioendothelioma or angiosarcoma)
  • Uncertain differentiation (e.g., synovial, epithelioid, alveolar soft part, clear cell, desmoplastic small round cell, extra-renal rhabdoid, malignant mesenchymoma, perivascular epithelioid cell tumor [PEComa], or intimal sarcoma)
  • Malignant peripheral nerve sheath tumors
  • Malignant solitary fibrous tumors
  • Undifferentiated soft tissue sarcomas not otherwise specified
  • Other types of sarcoma if approved by the study coordinator NOTE: *Includes malignant tumors of non-organ origin and skin and uterine leiomyosarcoma

• The following tumor types are excluded:

  • Embryonal rhabdomyosarcoma
  • Chondrosarcoma
  • Osteosarcoma
  • Ewing tumors/primitive neuroectodermal tumor (PNET)
  • Gastrointestinal stromal tumors
  • Dermatofibrosarcoma protuberans
  • Inflammatory myofibroblastic sarcoma
  • Neuroblastoma
  • Malignant mesothelioma
  • Mixed mesodermal tumors of the uterus
• Relapsed, refractory, and/or metastatic disease incurable by surgery or radiotherapy
• Measurable disease
• Must have formalin fixed paraffin-embedded tumor blocks and representative hematoxylin/eosin slides available for histological central review
• No symptomatic or known CNS metastases

PATIENT CHARACTERISTICS:

• At least 60 years of age OR ≥ 18 years of age if patient is not suitable for intensive combination chemotherapy treatments
• WHO performance status 0-1
• Absolute neutrophil count > 2,000/mm³
• Platelet count > 100,000/mm³
• Bilirubin ≤ 1.5 times upper limit of normal (ULN)
• AST and ALT ≤ 2.5 times ULN
• Alkaline phosphatase ≤ 2.5 times ULN
• Creatinine clearance ≥ 60 mL/min

• No serious cardiac illness within the past 6 months, including, but not limited to the following:

  • History of documented congestive heart failure
  • High-risk uncontrolled arrhythmias
  • Angina pectoris requiring antianginal medication
  • Clinically significant valvular heart disease
  • Evidence of transmural infarction on ECG
  • Poorly-controlled hypertension (e.g., systolic blood pressure [BP] > 180 mm Hg or diastolic BP > 100 mm Hg)
• Normal 12-lead ECG
• LVEF normal by MUGA or echocardiogram
• No other malignancy within the past 3 years except adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix or breast
• No other serious and/or unstable medical condition, illness, or lab abnormality that would preclude study participation
• No psychiatric illness or familial, social, or geographical condition that would preclude study compliance
• No active uncontrolled infection
• No known AIDS positivity
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

• No prior chemotherapy regimen for advanced or metastatic disease (neoadjuvant and adjuvant therapy allowed)
• No concurrent sargramostim (GM-CSF) except in cases of febrile neutropenia

• No other concurrent anticancer therapy or investigational agents, including any of the following:

  • Chemotherapy
  • Biological response modifiers
  • Hormone therapy
  • Immunotherapy
• No other concurrent clinical treatment trial participation