Carboplatin With or Without Decitabine in Treating Patients With Progressive, Advanced Ovarian Epithelial Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cancer

DISEASE CHARACTERISTICS:

• Histologically or cytologically proven ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer

  • Progressive disease as defined by RECIST criteria and/or CA-125 criteria
  • Advanced disease

• Previously treated with 1-2 prior platinum-containing regimen(s)

  • Prior hormonal therapy does not count towards the prior treatment
  • Responded to the most recent prior platinum-containing regimen(s) OR no evidence of progression during platinum-containing therapy as documented by RECIST criteria or CA-125 criteria (for patients with no macroscopic residual disease after surgery who are not evaluable by CA-125)

• Disease relapse 6-12 months after completion of the most recent platinum-containing therapy

  • Patients who received two prior lines of treatment must have had ≥ 6 months between their first and second lines of treatment
  • Patients with disease progression, as defined by CA-125 criteria alone, within 6 months after completion of their last treatment are eligible provided study treatment commences > 6 months after the last prior treatment
  • Patients with disease progression, as defined by GCIG guidelines, within 12 months after completion of their last treatment are eligible provided study treatment commences ≤ 14 months after the last prior treatment

• Measurable disease by RECIST criteria and/or CA-125 criteria

  • Measurable lesions are defined as those that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 20 mm by conventional techniques (physical examination, CT scan, x-ray, or MRI) or as ≥ 10 mm by spiral CT scan
  • Patients with evaluable disease by CA-125 criteria are eligible provided CA-125 is ≥ 2 times upper limit of normal (ULN) within 2 weeks prior to initiating study treatment
  • Disease is not considered measurable if patient received prior mouse antibodies or if there has been medical and/or surgical interference with the peritoneum or pleura (e.g., paracentesis) within the past 28 days

• Ascites requiring therapeutic drainage allowed only if there is measurable disease by RECIST criteria

  • Ascites that do not require therapeutic drainage allowed even if disease is evaluable by CA-125 criteria alone

PATIENT CHARACTERISTICS:

• WHO performance status 0-2
• Hemoglobin ≥ 10.0 g/dL
• WBC ≥ 3.0 x 10^9/L
• Neutrophil count ≥ 1.5 x 10^9/L
• Platelet count ≥ 100 x 10^9/L
• Bilirubin ≤ 30 μmol/L
• ALT and/or AST ≤ 2.5 times ULN (≤ 5 times ULN if due to tumor involvement of liver)
• EDTA/DTPA clearance ≥ 50 mL/min (uncorrected value)
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception for 4 weeks prior to, during, and for 6 months after completion of study treatment
• No known hepatitis B, hepatitis C, or HIV positivity
• No non-malignant systemic disease, including active uncontrolled infection, that would make the patient a high medical risk

• No other current malignancies, except adequately treated cone-biopsied in situ carcinoma of the cervix or basal cell or squamous cell carcinoma of the skin

  • Patients who have undergone potentially curative therapy for a prior malignancy are eligible provided there is no evidence of disease for ≥ 5 years and the patient is deemed to be at low risk for recurrence

• No intolerance to carboplatin (with a dose of ≥ AUC 5), as defined by any of the following:

  • Neutropenia or thrombocytopenia causing dose delay of > 4 days on more than 2 occasions
  • Grade III or IV hypersensitivity reaction (not controlled by a desensitization regimen)
  • Hospitalization for confirmed febrile neutropenia (fever ≥ 38°C)
  • Requirement for platelet transfusion
• No other condition that, in the investigator's opinion, would not make the patient a good candidate for this study

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• Recovered from prior therapy (alopecia, grade 1 neuropathy, and certain grade 1 toxicities allowed)
• More than 28 days since prior maintenance therapy (e.g., erlotinib or bevacizumab)
• More than 4 weeks since prior radiotherapy, endocrine therapy, immunotherapy, chemotherapy, biological therapy, or investigational agents
• More than 4 weeks since prior major thoracic and/or abdominal surgery and recovered
• No other concurrent anti-cancer therapy, including radiotherapy or investigational drugs