PHASE I PILOT STUDY OF SEQUENTIAL HIGH DOSE CYCLES OF CISPLATIN, CYCLOPHOSPHAMIDE, ETOPOSIDE AND IFOSFAMIDE, CARBOPLATIN AND TAXOL WITH AUTOLOGOUS STEM CELL SUPPORT

Date de début de l'étude : 1 décembre 1994

DISEASE CHARACTERISTICS: Histologically confirmed advanced carcinomas of the following types: Breast carcinoma that is ineligible for or patient has refused participation in a higher priority protocol in the following categories: Stage II disease with at least 10 involved lymph nodes and no evidence of disease (NED) following surgery Stage III disease rendered surgically NED with or without radiotherapy Stage IV disease following partial response (PR) or complete response (CR) to surgery, chemotherapy, or radiotherapy Prior high dose chemotherapy allowed at discretion of investigator No chemoresistant disease rendered surgically NED Locoregionally recurrent disease within 2 years of breast conservation with or without chemotherapy Stage III/IV ovarian cancer PR/CR following debulking surgery and/or chemotherapy Ineligible for or refused participation in higher priority protocols Primary soft tissue sarcoma with high-grade disease greater than 10 cm or that is metastatic Rendered surgically NED or achieved PR/CR on any chemotherapeutic or immunotherapeutic regimen Ineligible for or refused participation in higher priority protocols Malignant melanoma in the following categories: Ulcerative primary tumor with any number of completely resected metastatic lymph nodes Stage II disease with more than 4 involved nodes rendered NED Stage III disease rendered surgically NED or achieved PR/CR on any chemotherapeutic or immunotherapeutic regimen Osteosarcoma that is ineligible for or refused participation in higher priority protocols Resected primary with less than 50% tumor necrosis on pathologic review Metastatic disease rendered surgically NED or PR/CR on any chemotherapeutic, radiotherapeutic, or immunotherapeutic regimen The following diseases rendered surgically NED or that achieved PR/CR on any chemotherapeutic, radiotherapeutic, or immunotherapeutic regimen also eligible: Small cell bone carcinoma Metastatic Ewing's sarcoma Metastatic gastrointestinal malignancy Recurrent Wilms' tumor No CNS metastases No current histologically confirmed bone marrow metastases Prior bone metastases with resolution at time of entry permitted PATIENT CHARACTERISTICS: Age: Physiologic 18 to 55 Performance status: Karnofsky 80%-100% Hematopoietic: Absolute neutrophil count greater than 1,500/mm3 Platelet count greater than 120,000/mm3 Hemoglobin greater than 10 g/dL Hepatic: Bilirubin less than 1.5 mg/dL AST/ALT less than 3 times normal Renal: Creatinine less than 1.4 mg/dL Creatinine clearance at least 70 mL/min No history of hemorrhagic cystitis Cardiovascular: Ejection fraction at least 55% by MUGA No significant cardiac disease Pulmonary: FEV1 greater than 2 L pO2 (room air) greater than 70 mm Hg pCO2 (room air) less than 42 mm Hg DLCO greater than 60% of predicted Other: No potentially disabling psychosocial history No organic or functional CNS dysfunction or other medical problem that would present party at undue risk HIV negative Hepatitis B surface antigen negative No hearing loss greater than 40 decibels No contraindication to the following procedures: Collection by apheresis of up to 16 x 10 to the 8th mononuclear cells mobilized by G-CSF Collection of autologous bone marrow, if needed No second malignancy except: Nonmelanomatous skin cancer Carcinoma in situ of the cervix Not pregnant or nursing Adequate contraception required of fertile patients PRIOR CONCURRENT THERAPY: Biologic therapy: See Disease Characteristics At least 4 weeks since prior immunotherapy Chemotherapy: See Disease Characteristics No more than 3 prior chemotherapy regimens (excluding adjuvant therapy) No more than 200 mg per square meter of prior cisplatin No more than 800 mg per square meter of prior carboplatin No prior exposure to greater than 1,000 mg per square meter of "24-hour paclitaxel equivalents" (using a 1:1.3 ratio between paclitaxel doses given by 24-hour infusion and by 3-hour infusion) At least 4 weeks since prior chemotherapy Endocrine therapy: Not specified Radiotherapy: No prior radiotherapy to more than 20% of bone marrow At least 4 weeks since prior radiotherapy Surgery: See Disease Characteristics