Combination Chemotherapy in Treating Patients With Advanced Stomach Cancer

DISEASE CHARACTERISTICS:

• Histologically confirmed gastric carcinoma not amenable to curative surgery or in relapse after primary surgical resection

• Locally advanced disease (i.e., measurable locoregional lymph nodes) OR

• Metastatic disease

• Bidimensionally measurable disease

• At least 10 mm X 20 mm by chest x-ray or physical examination

• At least 10 mm X 10 mm by CT scan

• No CNS metastasis

PATIENT CHARACTERISTICS:

Age:

• 18 to 70

Performance status:

• 0-1

Life expectancy:

• Greater than 12 weeks

Hematopoietic:

• WBC count at least 4,000/mm^3

• Platelet count at least 100,000/mm^3

Hepatic:

• Bilirubin no greater than 1.25 times upper limit of normal (ULN)

• AST/ALT no greater than 2.5 times ULN

• Alkaline phosphatase no greater than 5 times ULN

Renal:

• BUN normal

• Creatinine normal

• Creatinine clearance at least 60 mL/min

• No severe hypercalcemia

Cardiovascular:

• No unstable cardiac disease requiring treatment

• No congestive heart failure

• No angina pectoris even if medically controlled

• No significant arrhythmias

• No prior myocardial infarction unless ejection fraction at least 50% by MUGA scan or echocardiogram

Neurologic:

• No prior significant neurologic or psychiatric disorders, including psychotic disorders, dementia or seizures that would preclude study

• No peripheral neuropathy of any origin (alcohol, etc.) greater than grade 1

Other:

• Fertile patients must use adequate contraception

• No prior malignancy except basal cell skin cancer or adequately treated carcinoma in situ of the cervix

• No active uncontrolled infection

• No other serious illness or medical condition that would preclude study participation

• No contraindication to corticosteroid use

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• No prior palliative chemotherapy

• At least 12 months since prior adjuvant or neoadjuvant chemotherapy

• No prior taxanes

• Prior fluorouracil allowed in bolus form only

• Prior cumulative dose of adjuvant or neoadjuvant cisplatin no greater than 300 mg/m2

Endocrine therapy:

• Prior or concurrent prednisone (or equivalent) allowed for prophylaxis, acute hypersensitivity reactions, or chronic therapy (greater than 6 months) at doses no greater than 20 mg

Radiotherapy:

• Not specified

Surgery:

• See Disease Characteristics

Other:

• No other concurrent experimental drugs

• No other concurrent anticancer therapies

• At least 30 days since treatment in prior clinical trial