Combination Chemotherapy and Bone Marrow Transplant in Treating Patients With Refractory or Recurrent Ovarian Cancer

OBJECTIVES:

• Determine the response rate, duration of response, and overall survival of patients with refractory or relapsed ovarian epithelial cancer treated with high-dose cyclophosphamide, carboplatin, and mitoxantrone followed by autologous bone marrow transplantation.
• Determine the nonhematopoietic toxicity of this regimen in these patients.

OUTLINE: Autologous bone marrow is harvested before study entry. Patients receive high-dose cyclophosphamide IV over 1 hour and mitoxantrone IV over 15 minutes on days -8, -6, and -4 and carboplatin IV continuously on days -8 to -3 in the absence of unacceptable toxicity. Bone marrow is reinfused on day 0 beginning at least 60 hours after completion of carboplatin infusion.

Patients are followed for survival.

PROJECTED ACCRUAL: A total of 15-30 patients will be accrued for this study within 1.5-3 years.

DISEASE CHARACTERISTICS:

• Diagnosis of refractory or relapsed ovarian epithelial cancer

• Must have failed prior regimen containing cisplatin or carboplatin
• Bidimensionally measurable or evaluable disease

• Serial CA-125 antigen titers or cytologically positive pleural effusion and/or ascites acceptable as evaluable disease
• Autologous bone marrow harvest of greater than 1.2 x 10 to the eighth nucleated cells/kg required before study entry
• No evidence of tumor at marrow harvest sites by bilateral bone marrow aspirates and biopsies, pelvic x-ray, and bone scan
• CNS involvement allowed

PATIENT CHARACTERISTICS:

Age:

• Under 65

Performance status:

• SWOG 0-2

Life expectancy:

• At least 8 weeks

Hematopoietic:

• WBC greater than 3,500/mm^3
• Platelet count greater than 100,000/mm^3
• Hemoglobin greater than 10.0 g/dL

Hepatic:

• Bilirubin less than 2.0 mg/dL
• SGOT and SGPT less than 2 times upper limit of normal

Renal:

• Creatinine clearance greater than 60 mL/min
• No prior hemorrhagic cystitis

Cardiovascular:

• LVEF greater than 45% by MUGA scan

Other:

• No hearing loss in voice tones
• No active infection
• No psychological contraindication to study treatment
• Not pregnant
• Negative pregnancy test
• HIV negative
• General medical condition must allow general anesthesia

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• See Disease Characteristics
• No prior bone marrow transplantation
• More than 4 weeks since other prior biologic therapy and recovered

Chemotherapy:

• See Disease Characteristics
• More than 4 weeks since prior chemotherapy (at least 6 weeks for nitrosoureas or mitomycin) and recovered

Endocrine therapy:

• Not specified

Radiotherapy:

• More than 4 weeks since prior radiotherapy and recovered

Surgery:

• Not specified