Gefitinib in Treating Patients With Locally Advanced or Metastatic Synovial Sarcoma

OBJECTIVES:

• Determine the therapeutic activity of gefitinib, in terms of progression-free rate, in patients with locally advanced or metastatic synovial sarcoma expressing HER1.
• Determine the toxicity of this drug in these patients.
• Determine the objective response, in terms of time to onset and duration of response, in patients treated with this drug.
• Determine the overall survival of patients treated with this drug.

OUTLINE: This is a non-randomized, multicenter study.

Patients receive oral gefitinib twice daily. Treatment continues in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months.

PROJECTED ACCRUAL: A total of 14-44 patients will be accrued for this study within 18 months.

DISEASE CHARACTERISTICS:

• Histologically proven advanced or metastatic synovial sarcoma that is not amenable to surgery, radiotherapy, or combined modality treatment with curative intent
• HER1 antigen expression
• Must have received at least 1 prior chemotherapy regimen comprising doxorubicin and/or ifosfamide
• At least 1 measurable lesion with evidence of progression within 3 months of study

• Osseous lesions and pleural effusions are not considered measurable
• No symptomatic or known CNS metastases

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• WHO 0-2

Life expectancy

• Not specified

Hematopoietic

• WBC greater than 3,000/mm^3
• Granulocyte count greater than 1,000/mm^3
• Platelet count greater than 100,000/mm^3

Hepatic

• Bilirubin no greater than 1.5 times upper limit of normal (ULN)
• Albumin at least 25 g/L

Renal

• Creatinine no greater than 2 times ULN OR
• Creatinine clearance greater than 65 mL/min

Cardiovascular

• No history of severe cardiovascular disease

Pulmonary

• No evidence of clinically active interstitial lung disease

• Asymptomatic chronic stable radiographic changes allowed

Other

• Not pregnant or nursing
• Fertile patients must use effective contraception
• No known severe hypersensitivity to gefitinib or any of its excipients
• No other primary malignant tumor except adequately treated carcinoma in situ of the cervix, basal cell skin cancer, or any other malignant tumor in complete remission for at least 3 years
• No other severe medical illness
• No psychosis
• No psychological, familial, sociological, or geographical condition that would preclude study compliance

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Not specified

Chemotherapy

• See Disease Characteristics
• At least 28 days since prior chemotherapy and recovered

Endocrine therapy

• Not specified

Radiotherapy

• At least 3 months since prior radiotherapy to measurable lesion and recovered
• No concurrent radiotherapy for soft tissue sarcoma
• Concurrent palliative radiotherapy to nontarget lesions allowed

Surgery

• Not specified

Other

• More than 28 days since prior unapproved or investigational drugs and recovered
• No concurrent phenytoin, carbamazepine, rifampin, barbiturates, or Hypericum perforatum (St. John's Wort)
• No other concurrent cytostatic agents
• No other concurrent tyrosine kinase activity inhibitors
• No other concurrent systemic therapy for soft tissue sarcoma