Temozolomide, Vincristine, and Irinotecan in Treating Young Patients With Refractory Solid Tumors

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically confirmed\* malignant solid tumor, including brain tumor, at original diagnosis or relapse
• * Refractory disease NOTE: \*Histologic confirmation not required for intrinsic brain stem tumors
• Measurable or evaluable disease
• No known curative therapy OR therapy proven to prolong survival with an acceptable quality of life exists
• No known bone marrow metastases
• PATIENT CHARACTERISTICS:
• Age
• 1 to 21
• Performance status
• Lansky 50-100% (for patients ≤ 10 years of age)
• Karnofsky 50-100% (for patients \> 10 years of age)
• Life expectancy
• Not specified
• Hematopoietic
• Absolute neutrophil count ≥ 1,000/mm\^3
• Platelet count ≥ 100,000/mm\^3 (transfusion independent)
• Hemoglobin ≥ 8.0 g/dL (RBC transfusions allowed)
• Hepatic
• ALT ≤ 110 U/L (upper limit of normal \[ULN\] for ALT is 45 U/L)
• Bilirubin ≤ 1.5 times ULN
• Albumin ≥ 2 g/dL
• Renal
• Creatinine clearance or radioisotope glomerular filtration rate ≥ 70 mL/min OR
• Creatinine based on age as follows:
• * No greater than 0.8 mg/dL (for patients ≤ 5 years of age)
• * No greater than 1.0 mg/dL (for patients 6 to 10 years of age)
• * No greater than 1.2 mg/dL (for patients 11 to 15 years of age)
• * No greater than 1.5 mg/dL (for patients \> 15 years of age)
• Other
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• Neurologic deficits in patients with CNS tumors must be stable for ≥ 1 week prior to study entry
• No uncontrolled infection
• No documented allergy to cephalosporins or dacarbazine
• PRIOR CONCURRENT THERAPY:
• Biologic therapy
• Recovered from prior immunotherapy
• At least 3 months since prior stem cell transplantation or rescue without total-body irradiation
• * No evidence of active graft-versus-host disease
• At least 7 days since prior antineoplastic biologic agents
• At least 7 days since prior hematopoietic growth factors
• No concurrent biologic therapy or immunotherapy
• No concurrent prophylactic filgrastim (G-CSF) during the first course of study treatment
• Chemotherapy
• Recovered from prior chemotherapy
• Prior temozolomide, vincristine, irinotecan, or topotecan allowed
• * No prior coadministration of temozolomide and irinotecan
• * No disease progression during treatment with either irinotecan or temozolomide
• More than 3 weeks since prior myelosuppressive chemotherapy (6 weeks for nitrosoureas)
• No other concurrent chemotherapy
• Endocrine therapy
• Patients with CNS tumors must be on a stable or decreasing dose of dexamethasone for ≥ 7 days prior to study entry
• Radiotherapy
• Recovered from prior radiotherapy
• At least 6 months since prior total-body irradiation, craniospinal radiotherapy, or radiotherapy to ≥ 50% of the pelvis
• At least 6 weeks since other prior substantial bone marrow radiotherapy
• At least 2 weeks since prior local palliative radiotherapy (small port)
• No concurrent radiotherapy
• Surgery
• Not specified
• Other
• No other concurrent investigational drugs
• No other concurrent anticancer therapy
• No concurrent enzyme-inducing anticonvulsants, including any of the following:
• * Phenobarbital
• * Phenytoin
• * Carbamazepine
• * Oxcarbazepine
• No concurrent administration of any of the following:
• * Rifampin
• * Voriconazole
• * Itraconazole
• * Ketoconazole
• * Aprepitant
• * Hypericum perforatum (St. John's wort)
• No concurrent treatment for clostridium difficile infection