Dasatinib in Treating Patients With Previously Treated Malignant Mesothelioma

This is an interventional treatment trial for Malignant Mesothelioma focused on measuring advanced malignant mesothelioma, epithelial mesothelioma, recurrent malignant mesothelioma, sarcomatous mesothelioma Read More

DISEASE CHARACTERISTICS:

• Histologically confirmed malignant mesothelioma of any of the following subtypes:

  • Epithelial
  • Sarcomatoid
  • Mixed

• Any site of origin of malignant mesothelioma allowed including, but not limited to, any of the following:

  • Pleura
  • Peritoneum
  • Pericardium
  • Tunica vaginalis
• Pathology blocks or slides from a core surgical biopsy must be available
• Not amenable to curative surgery

• Measurable disease, defined as lesions that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 20 mm with conventional techniques (CT scan , MRI, or x-ray) or as ≥ 10 mm with spiral CT scan

  • Patients with pleural rind only disease must have at least one level with one rind measurement ≥ 1.5 cm

  • Lesions that are considered nonmeasurable include the following:

    • Bone lesions
    • Leptomeningeal disease
    • Ascites
    • Pleural/pericardial effusion
    • Lymphangitis cutis/pulmonis
    • Abdominal masses that are not confirmed and followed by imaging techniques
    • Cystic lesions

• Prior treatment with one and only one systemic chemotherapy regimen, which must have included pemetrexed disodium required

  • Treatment may have been with pemetrexed disodium alone or in combination with any other agent

• No symptomatic pleural effusions, unless the patient undergoes a therapeutic thoracentesis

  • Patients with pleural effusions who have had a pleurodesis are eligible
• No known brain metastases
• May be registered on CALGB-150707 companion study

PATIENT CHARACTERISTICS:

• ECOG performance status 0-1
• Granulocytes ≥ 1,500/μL
• Platelet count ≥ 100,000/μL
• Total bilirubin ≤ 2 x upper limit of normal (ULN)
• AST (SGOT) ≤ 2.5 x ULN
• Creatinine clearance ≥ 60 mL/min
• INR < 1.5
• PTT < 40 seconds
• QTc < 450 msec
• Not pregnant or nursing
• Fertile patients must use effective contraception

• No significant cardiac disease, including any of the following:

  • New York Heart Association (NYHA) class III-IV congestive heart failure (CHF)
  • Unstable angina
  • Myocardial infarction or ventricular tachyarrhythmia within 6 months of study entry
  • Ejection fraction less than institutional normal (in patients with a history of CHF or currently with NYHA class I or II CHF)
  • Prolonged QTc > 450 msec (Fridericia correction)
  • Major conduction abnormality, unless a cardiac pacemaker is present
  • Hypokalemia or hypomagnesemia that cannot be corrected

• No history of significant bleeding disorder unrelated to cancer, including any of the following:

  • Congenital bleeding disorder (e.g., von Willebrand disease)
  • Acquired bleeding disorder within the past year (e.g., acquired anti-factor VIII antibodies)
  • Ongoing or recent (≤ 3 months) significant GI bleeding or hemoptysis
• No requirement for supplemental oxygen (i.e., pulse oximetry < 89% at rest)

PRIOR CONCURRENT THERAPY:

• At least 4 weeks since prior pemetrexed disodium-containing chemotherapy
• At least 4 weeks since prior major surgery

• At least 4 weeks since prior radiation therapy

  • Measurable disease must be outside the radiation port

• Prior intracavitary cytotoxic or sclerosing therapy (including bleomycin) allowed

  • Intrapleural cytotoxic chemotherapy will not be considered systemic chemotherapy

• At least 7 days since prior and no concurrent antithrombotic or anti-platelet agents, including any of the following:

  • Aspirin or aspirin-containing combinations
  • Clopidogrel
  • Dipyridamole
  • Tirofiban
  • Epoprostenol
  • Eptifibatide
  • Cilostazol
  • Abciximab
  • Ticlopidine

  • Warfarin

    • Low-dose warfarin for prophylaxis to prevent catheter thrombosis allowed

  • Heparin or low molecular weight heparin

    • Heparin for IV line flush allowed

• At least 7 days since prior and no concurrent use of the following drugs:

  • Itraconazole
  • Ketoconazole (at doses > 200 mg/day)
  • Miconazole
  • Voriconazole
  • Telithromycin
  • Primidone
  • Rifabutin
  • Rifampin
  • St. John's wort
  • Carbamazepine
  • Oxcarbazepine
  • Rifapentine
  • Phenobarbital
  • Phenytoin
  • Quinidine
  • Procainamide
  • Disopyramide
  • Amiodarone
  • Sotalol
  • Ibutilide
  • Dofetilide
  • Erythromycin
  • Clarithromycin
  • Chlorpromazine
  • Haloperidol
  • Mesoridazine
  • Thioridazine
  • Pimozide
  • Bepridil
  • Droperidol
  • Halofantrine
  • Levomethadyl
  • Sparfloxacin
• No concurrent H2 blockers or proton pump inhibitors
• No bisphosphonate therapy during the first 8 weeks of study treatment
• No concurrent hormones or other chemotherapeutic agents except for steroids administered for dasatinib-related pleural effusion or hormones administered for non-disease-related conditions (e.g., insulin for diabetes)
• No concurrent palliative radiation therapy