Erlotinib and Radiation Therapy in Treating Older Patients With Stage I, Stage II, Stage III, or Stage IV Esophageal Cancer

DISEASE CHARACTERISTICS:

• Biopsy-proven primary squamous cell carcinoma or adenocarcinoma of the esophagus or gastroesophageal (GE) junction

  • GE junction tumors with 50% or more tumor located in the esophagus determined by radiologic or endoscopic evaluation

  • Stage I-IVA disease determined by CT scan or MRI of the chest and abdomen

    • Stage IVB disease allowed if metastases to distant regional lymph nodes (celiac or cervical) only and no other sites

• Not a surgical candidate and ineligible for chemotherapy due to any of the following:

  • Neuropathy
  • Cardiac disease
  • Performance status 2
  • General overall condition felt by the investigator to be a contraindication to platinum-based therapy
• Bronchoscopy with biopsy and cytology required if primary esophageal cancer is < 26 cm from incisors
• No evidence of clinically active interstitial lung disease (patients who are asymptomatic with chronic, stable, radiographic lung changes allowed)

PATIENT CHARACTERISTICS:

• ECOG performance status 0-2
• Life expectancy > 4 months
• WBC ≥ 3,000/mm³
• ANC ≥ 1,500/mm³
• Platelet count > 100,000/mm³
• Bilirubin ≤ 1.3 mg/dL
• ALT and AST ≤ 2.5 times upper limit of normal (ULN)
• Alkaline phosphatase ≤ 2.5 times ULN
• No prior malignancies except basal cell or squamous cell skin cancer, in situ cervical cancer, or superficial transitional cell bladder cancer, unless diagnosed and/or treated > 2 years prior to current study and are without evidence of recurrence
• No history of allergy to erlotinib or any of its excipients
• No serious, uncontrolled, concurrent infection
• No clinically serious, uncontrolled medical conditions that the investigator feels might compromise study participation
• No lack of physical integrity of the upper gastrointestinal tract or malabsorption syndrome
• No unwillingness to participate or inability to comply with the protocol for the duration of the study

PRIOR CONCURRENT THERAPY:

• No prior chemotherapy or radiotherapy for this tumor
• No prior resection or attempted resection of esophageal cancer
• No prior anti-epidermal growth factor receptor therapy (unless given in an adjuvant setting and completed at least 12 months earlier)
• No participation in any investigational drug study within the past 4 weeks
• No HIV-positive patients receiving antiretroviral therapy
• No concurrent CYP3A4/5 inducers or inhibitors