Gemcitabine Hydrochloride and Tanespimycin in Treating Patients With Recurrent Advanced Ovarian Epithelial or Peritoneal Cavity Cancer

Inclusion Criteria:

• Diagnosis of ovarian epithelial or primary peritoneal cavity cancer

  • Relapsed disease
  • Persistent disease

• Platinum-resistant disease, defined as having evidence of disease that would be expected to be non-responsive to additional platinum-containing regimens or contraindication to platinum-based chemotherapy and 1 of the following:

  • Failure to obtain a complete response to initial platinum therapy
  • Recurrence < 6 months after completing a platinum-containing regimen for initial or recurrent disease
  • Any of the above situations and following treatment with additional chemotherapy regimens (e.g., non-platinum containing regimens)
  • Relative or absolute contraindication to platinum-based chemotherapy regimens (e.g., platinum allergy) as determine by the investigator

• Measurable or evaluable disease

  • Patients with a rising CA 125 level, even in the absence of other indicators of disease, allowed provided CA 125 is ≥ 2 times upper limit of normal (ULN)
• Patients with accessible disease must be willing to undergo tumor biopsies
• No CNS metastases
• Performance status - ECOG 0-2
• WBC ≥ 3,000/mm^3
• Platelet count ≥ 100,000/mm^3
• Hemoglobin ≥ 9.0 g/dL
• Bilirubin normal
• Alkaline phosphatase ≤ 2.5 times ULN
• AST ≤ 2.5 times ULN
• Creatinine ≤ 1.5 times ULN
• Ejection fraction > 40% by ECHO for patients with prior anthracycline therapy

• No significant cardiac disease including any of the following:

  • New York Heart Association class III or IV heart disease
  • History of myocardial infraction within the past year
  • Uncontrolled dysrhythmias or requirement for antiarrhythmic drugs
  • Poorly controlled angina
• No history of serious ventricular arrhythmia (i.e., ventricular tachycardia or ventricular fibrillation ≥ 3 beats in a row)
• No history of QTc ≥ 500 msec
• No active ischemic heart disease within the past 12 months
• No congenital long QT syndrome
• No left bundle branch block
• No cardiac symptoms ≥ grade 2
• No history of cardiac toxicity after receiving anthracyclines (e.g., doxorubicin hydrochloride, daunorubicin hydrochloride, mitoxantrone, bleomycin, or carmustine)
• Does not meet the medicare criteria for home oxygen
• No pulse oximetry at rest and exercise < 88%

• No symptomatic pulmonary disease requiring medication including any of the following:

  • Dyspnea on or off exertion
  • Paroxysmal nocturnal dyspnea
  • Oxygen requirement
  • Significant pulmonary disease (e.g., chronic obstructive/restrictive pulmonary disease)
• No pulmonary symptoms ≥ grade 2
• No history of pulmonary toxicity after receiving anthracyclines (e.g., doxorubicin hydrochloride, daunorubicin hydrochloride, mitoxantrone, bleomycin, or carmustine)
• K+, Mg ++, and Ca ++ normal
• No seizure disorder
• No uncontrolled infection
• No history of serious allergic reaction to eggs
• More than 4 weeks since prior immunotherapy
• More than 4 weeks since prior biologic therapy
• No concurrent immunotherapy
• No concurrent routine or prophylactic colony-stimulating factors (e.g., filgrastim [G-CSF] or sargramostim [GM-CSF])
• See Disease Characteristics
• More than 4 weeks since prior chemotherapy (6 weeks for mitomycin or nitrosoureas) and recovered

• Prior gemcitabine hydrochloride allowed provided 1 of the following criteria is met:

  • Patients have no prior exposure to gemcitabine hydrochloride
  • Patients who have prior exposure to gemcitabine hydrochloride as a single agent have experienced progressive disease while on treatment
• No other concurrent chemotherapy
• No prior radiotherapy to > 25% of bone marrow

• No history of radiotherapy that potentially included the heart in the field (e.g., mantle)

  • Chest wall irradiation or other radiotherapy techniques that do not include the heart in the radiation field area allowed
• More than 4 weeks since prior radiotherapy
• More than 4 weeks since prior radiopharmaceuticals
• No concurrent radiotherapy
• No other concurrent investigational therapy
• No concurrent medications that may prolong QTc