Docetaxel in Treating Children With Recurrent Solid Tumors

OBJECTIVES:

I. Determine the response rate to docetaxel in children with recurrent sarcomas, neuroblastomas, or brain tumors.

II. Describe the toxic effects of docetaxel in these patients.

OUTLINE:

All patients receive docetaxel with G-CSF every 21 days for up to 12 courses. Patients are followed for survival.

DISEASE CHARACTERISTICS:

• Histologically verified (at original diagnosis) solid tumor that is relapsed or refractory The following histologies are eligible:
• Sarcomas: Rhabdomyosarcoma Ewing's sarcoma, Peripheral neuroectodermal tumor (PNET), Osteosarcoma, Other soft tissue sarcomas
• Brain tumors: Ependymoma Primitive neuroectodermal tumor (PNET), High grade astrocytoma, Brain stem glioma (histologic verification not required), Neuroblastoma
• Measurable disease that can be followed clinically or radiologically required
• The following not considered measurable: Bone lesions measured by bone scan or bone marrow involvement
• Central nervous system disease documented by cerebrospinal fluid cytology
• Pleural effusion

PATIENT CHARACTERISTICS:

• Age: 21 and under at original diagnosis
• Performance status: 0-3
• Life expectancy: Greater than 2 months
• In the absence of marrow involvement:
• Absolute neutrophil count at least 1,000/mm3
• Platelet count at least 100,000/mm3 (transfusion independent)
• Hemoglobin at least 9.0 g/dL (transfusion allowed)
• With bone marrow involvement:
• Absolute neutrophil count at least 750/mm3
• Red cell and platelet support possible
• Bilirubin normal
• ALT/AST less than 1.5 times normal
• Alkaline phosphatase less than 2.5 times normal
• Creatinine no greater than 1.5 times normal OR creatinine clearance or radioisotope glomerular filtration rate at least 60 mL/min
• Not pregnant or nursing
• Adequate contraception required of fertile women

PRIOR CONCURRENT THERAPY:

• Prior bone marrow transplantation allowed:
• Must have stable engraftment without need for significant blood product support or cytokine therapy
• No concurrent immunomodulating agents
• No prior paclitaxel or docetaxel At least 2 weeks since chemotherapy (4 weeks since nitrosoureas)
• No other concurrent cancer chemotherapy
• Concurrent corticosteroids allowed for intracranial pressure in brain tumor patients provided patient has been stable for at least 4 weeks
• Corticosteroids allowed as pretreatment for docetaxel
• At least 2 months since extensive radiotherapy, defined as:
• Craniospinal Volume greater than 50% of abdominopelvic cavity
• Volume greater than one third of lung volume
• No concurrent radiotherapy
• No more than 2 prior therapies and fully recovered