2-Methoxyestradiol in Treating Patients With Advanced Solid Tumors

OBJECTIVES:

• Determine the maximum tolerated dose of 2-methoxyestradiol in patients with advanced solid tumors.
• Determine the side effect profile of this drug in these patients.
• Determine the pharmacokinetic profile of this drug in these patients.
• Determine the changes in positron-emission tomography scans of patients treated with this drug.
• Determine the changes in apotosis in patients treated with this drug.

OUTLINE: This is a dose-escalation study.

Patients receive oral 2-methoxyestradiol (2ME2) once on day 1 followed by 2 days of evaluation. Patients then receive oral 2ME2 every 12 hours. Treatment continues in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of 2ME2 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

Patients are followed at day 30.

PROJECTED ACCRUAL: A total of 30 patients will be accrued for this study within 1 year.

DISEASE CHARACTERISTICS:

• Histologically confirmed solid tumor

• Metastatic or unresectable disease for which standard curative treatments do not exist or are no longer effective
• Clinically progressive disease documented by any of the following:

• New area of malignant disease
• Progression of soft-tissue metastases
• At least 1 new metastatic deposit on technetium Tc 99m bone scintigraphy
• Increases in prostate-specific antigen
• Lesions accessible for serial biopsy
• No known brain metastases

PATIENT CHARACTERISTICS:

Age:

• 18 and over

Performance status:

• ECOG 0-2 OR
• Karnofsky 60-100%

Life expectancy:

• More than 3 months

Hematopoietic:

• WBC at least 3,000/mm^3
• Absolute neutrophil count at least 1,500/mm^3
• Platelet count at least 100,000/mm^3

Hepatic:

• Bilirubin normal
• AST/ALT no greater than 2.5 times upper limit of normal

Renal:

• Creatinine normal OR
• Creatinine clearance at least 60 mL/min

Cardiovascular:

• No symptomatic congestive heart failure
• No unstable angina pectoris
• No cardiac arrhythmia

Other:

• No other concurrent uncontrolled illness
• No ongoing or active infection
• No prior allergic reactions to compounds of similar chemical or biological composition to 2-methoxyestradiol
• No psychiatric illness or social situation that would preclude study compliance
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception for 1 month before, during, and for 1 month after study participation

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• At least 4 weeks since prior biologic therapy

Chemotherapy:

• At least 4 weeks since prior chemotherapy (6 weeks for mitomycin, nitrosoureas, or carboplatin)
• No concurrent chemotherapy for cancer

Endocrine therapy:

• Luteinizing-hormone releasing-hormone agonist therapy must be continued for patients with prostate cancer except those with prior orchiectomy

Radiotherapy:

• At least 4 weeks since prior radiotherapy
• No concurrent radiotherapy for cancer

Surgery:

• See Endocrine therapy

Other:

• Recovered from prior therapy
• No other concurrent therapy for cancer
• No concurrent combination antiretroviral therapy for HIV-positive patients