Combination Chemotherapy in Treating Patients With Colorectal Cancer

DISEASE CHARACTERISTICS:

• Histologically confirmed adenocarcinoma of the colon or rectum

  • Metastatic, locally advanced, or recurrent disease

• Patients must have at least 2 generations (parents and grandparents) who belong to one of the following racial groups:

  • Asian or Pacific Islander (e.g., China, Japan, Korea, the Philippine Islands, or Samoa)
  • Black (originating from the black racial groups of Africa)
  • Hispanic (originating from Mexico, Puerto Rico, Cuba, Central or South America, or other Spanish culture)
  • White (originating from the peoples of Europe, North Africa, or the Middle East)
• No patients with parents or grandparents of mixed race or race other than that of the patient

PATIENT CHARACTERISTICS:

Age:

• Not specified

Performance status:

• CTC 0-2

Life expectancy:

• Not specified

Hematopoietic:

• Granulocyte count at least 1,500/mm3
• Platelet count at least 100,000/mm3

Hepatic:

• Bilirubin no greater than 1.5 mg/dL
• AST no greater than 3 times upper limit of normal

Renal:

• Creatinine no greater than 1.5 mg/dL

Other:

• Not pregnant or nursing
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• Prior adjuvant fluorouracil allowed if relapse occurred at least 6 months after completion of fluorouracil
• At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin)
• No prior irinotecan
• No other concurrent chemotherapy

Endocrine therapy:

• No concurrent hormones except steroids for adrenal failure, hormones for nondisease related conditions (e.g., insulin for diabetes), or intermittent dexamethasone as an antiemetic
• No concurrent prednisone

Radiotherapy:

• At least 4 weeks since prior radiotherapy (except to bone or soft tissue involving less than 25% of bone marrow)
• No concurrent radiotherapy

Surgery:

• At least 4 weeks since prior major surgery

Other:

• No concurrent phenobarbital, valproate, or cyclosporine

• None of the following concurrently during first course of therapy:

  • Macrolide antibiotics (e.g., azithromycin, erythromycin, clarithromycin, troleandomycin, dapsone)
  • Azole antibiotics (e.g., fuconazole, miconazole, itraconazole, ketoconazole)
  • Triazobenzodiazepines (e.g., alprazolam, midazolam, triazolam)
  • Antidepressants (e.g., fluoxetine, setraline hydrochloride, fluoxamine, nefazodone hydrochloride)
  • Quinolone antimicrobials (e.g., ciprofloxacin, ofloxacin)
  • Imidazole antibiotics (e.g., clotrimazole)
  • Anti-ulcer medications (e.g., omeprazole, lansoprazole)
  • Ethinyl estradiol
  • Diltiazem
  • Cimetidine hydrochloride
  • Cisapride
  • Terfenadine
  • Rifampin
  • Glucocorticoids
  • Antiepileptics
  • Grapefruit juice