Bortezomib, Paclitaxel, and Carboplatin in Treating Patients With Unresectable, Metastatic Cancer of the Esophagus or Gastroesophageal Junction

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed adenocarcinoma of 1 of the following sites:

  • Esophagus
  • Gastroesophageal junction

  • Gastric cardia

    • No greater than 2 cm from the gastroesophageal junction into the stomach
• Unresectable, metastatic disease
• Not a candidate for potentially curative therapy AND no other more reasonable potentially curative conventional therapy exists
• At least 1 measurable lesion ≥ 2.0 cm by conventional techniques OR ≥ 1.0 cm by spiral CT scan
• No known CNS metastases

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• ECOG 0-2

Life expectancy

• At least 12 weeks

Hematopoietic

• Absolute neutrophil count ≥ 1,500/mm^3
• Platelet count ≥ 100,000/mm^3

Hepatic

• Bilirubin normal
• AST ≤ 3 times upper limit of normal (ULN)
• Alkaline phosphatase ≤ 2 times ULN

Renal

• Creatinine ≤ 1.5 times ULN

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for up to 6 months after completion of study treatment
• No peripheral neuropathy ≥ grade 2
• No uncontrolled infection
• No chronic debilitating disease
• No prior allergic reaction to carboplatin or paclitaxel
• No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer

PRIOR CONCURRENT THERAPY:

Biologic therapy

• No prior immunotherapy for recurrent or metastatic disease
• No prior biologic therapy for recurrent or metastatic disease
• No concurrent prophylactic colony-stimulating factors (filgrastim [G-CSF] or sargramostim [GM-CSF])

Chemotherapy

• No prior chemotherapy for recurrent or metastatic disease
• Prior chemotherapy in the neoadjuvant or adjuvant setting (after complete resection of the original tumor) allowed
• Prior combination chemotherapy and radiotherapy allowed provided patient achieved a complete response AND the last dose of combination therapy was administered ≥ 6 months ago

Endocrine therapy

• Not specified

Radiotherapy

• See Chemotherapy
• No prior radiotherapy for recurrent or metastatic disease
• Prior radiotherapy in the neoadjuvant or adjuvant setting (after complete resection of the original tumor) allowed
• No prior radiotherapy to > 25% of bone marrow for locally advanced disease
• More than 4 weeks since prior radiotherapy

Surgery

• More than 4 weeks since prior open abdominal exploration (e.g., laparotomy)
• More than 2 weeks since prior minimally invasive procedures (e.g., laparoscopy)