Irinotecan, Oxaliplatin, and Capecitabine as First-Line Therapy in Treating Patients With Metastatic or Unresectable Locally Advanced Small Bowel Cancer

Histologic or cytologic confirmation of adenocarcinoma consistent with small bowel origin; biopsy can be of primary tumor or can be from a metastatic site if there is a primary small bowel tumor currently or previously present

Measurable disease; for patients with lesions \>= 1 cm but \< 2 cm, spiral computed tomography (CT) scan imaging must be used for tumor assessments

Life expectancy \>= 12 weeks

Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, or 2

\>= 4 weeks since prior major surgery to time of registration

\>= 2 weeks from completion of any radiation treatment

Absolute neutrophil count (ANC) \>= 1,500/mm\^3

Platelets \>= 100,000/mm\^3

Serum glutamic oxaloacetic transaminase (SGOT) =\< 5 x upper normal limit (UNL); =\< 2.5 x UNL if no liver metastases

Total bilirubin:

* For 6/6 patients: =\< upper limit of normal (ULN)

* For 6/7 or 7/7 patients: =\< 2.0 x ULN

Hemoglobin \>= 9.0 g/dL

Creatinine =\< 1.5 x UNL (if \> 1.5 x UNL, calculated creatinine clearance should be checked.; if it is \> 60 mL/min, then the patient is eligible for the study)

Negative pregnancy test done =\< 7 days prior to registration, for women of childbearing potential only

Prior chemotherapy regimen for advanced small bowel cancer (prior adjuvant chemotherapy with fluorouracil (5FU)/leucovorin is permitted if last dose was administered \>= 3 months prior to registration); prior oxaliplatin or irinotecan use as adjuvant therapy is not permitted

Prior radiotherapy to \> 25% of bone marrow

Active or uncontrolled infection

Evidence of serious intercurrent illness (e.g., unstable angina, symptomatic congestive heart failure, serious uncontrolled cardiac arrhythmia)

Pregnant women; women of child-bearing potential and men must agree to use adequate contraception (diaphragm, birth control pills, injections, foams, intrauterine device \[IUD\], or abstinence, etc.) for the duration of study participation; if a woman becomes pregnant or suspects that she is pregnant while participating in this study, she should inform her treating physician immediately and all study treatment discontinued

Nursing women; breast-feeding should be discontinued when the mother is treated with these agents

Men or women of childbearing potential who are unwilling to employ adequate contraception

Current evidence of other malignancy besides small bowel adenocarcinoma, with exception of non-melanoma skin cancer

Known central nervous system metastases or carcinomatous meningitis

Preexisting sensory neuropathy \>= grade 2 from any cause interfering with function

Concurrent therapy with sorivudine, brivudine, lamivudine, or stavudine

What this study is about