Combination Chemotherapy in Treating Patients With Stage III, Stage IV, or Recurrent Endometrial Cancer

DISEASE CHARACTERISTICS:

• Histologically confirmed endometrial carcinoma

  • FIGO stage III or IV or recurrent disease
• Must know estrogen and progesterone status of the primary tumor
• Poor potential for curative treatment by radiotherapy and/or surgery

• At least 1 unidimensionally measurable lesion (for patients with stage III disease only)

  • At least 20 mm by conventional techniques (e.g., palpation, plain x-ray, CT scan, or MRI) OR at least 10 mm by spiral CT scan
  • Disease in a previously irradiated field acceptable as the only site of measurable disease only if there has been clear progression since completion of radiotherapy

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• GOG 0-2

Life expectancy

• Not specified

Hematopoietic

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

Hepatic

• Bilirubin normal
• ALT no greater than 3 times upper limit of normal

Renal

• Creatinine no greater than 1.6 mg/dL

Cardiovascular

• LVEF at least 50%
• Cardiac conduction abnormalities or dysfunction allowed at the investigator's discretion
• No third-degree or complete heart block without a pacemaker
• No uncontrolled angina
• No myocardial infarction within the past 6 months
• No New York Heart Association class II -IV heart failure
• No symptoms of congestive heart failure

Other

• Not pregnant or nursing
• Fertile patients must use effective non-hormonal contraception during and for at least 2 months after study participation
• No other invasive malignancy within the past 5 years except patients who have nonmelanoma skin cancer or have received prior chemotherapy for that malignancy
• No serious uncontrolled infection
• No serious peripheral neuropathy
• No other concurrent medical illness that would preclude study therapy
• No circumstances that would preclude study completion or follow-up
• No sensitivity to Escherichia coli-derived drug preparations
• No uterine carcinosarcoma or other non-epithelial uterine malignancy

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Prior biologic therapy allowed
• No concurrent biologic therapy

Chemotherapy

• No prior cytotoxic chemotherapy (including radiotherapy sensitization) for this or any other malignancy

Endocrine therapy

• Prior hormonal therapy allowed
• No concurrent hormonal therapy

Radiotherapy

• See Disease Characteristics
• At least 4 weeks since prior radiotherapy to the whole pelvis or over 50% of the spine
• No concurrent radiotherapy

Surgery

• Not specified

Other

• Concurrent medications that alter cardiac conduction (e.g., digitalis, beta blockers, or calcium channel blockers) are allowed at the investigator's discretion