Chemotherapy in Treating Patients With Cancer of Unknown Primary Origin

DISEASE CHARACTERISTICS:

• Histologically confirmed adenocarcinoma of any differentiation grade

  • Excludes the following "treatable" conditions:

    • Axillary node involvement
    • Peritonitis carcinomatosis
    • Blastic bone metastases and/or elevated PSA
    • Squamous cell cancer with cervical or inguinal presentation

    • Poorly differentiated carcinoma

      • Neuroendocrine tumors OR
      • Tumors located in the mediastinum, retroperitoneum, or nodes
• At least one measurable metastatic site
• No brain or meningeal metastases

PATIENT CHARACTERISTICS:

Age:

• Over 18

Performance status:

• ECOG 0-2

Hematopoietic:

• Leukocyte count at least 4,000/mm3
• Thrombocyte count at least 100,000/mm3

Hepatic:

• Bilirubin less than 1.4 mg/dL
• AST and ALT less than 3 times upper limit of normal
• No cirrhosis of the liver

Renal:

• Creatinine less than 1.7 mg/dL

Cardiovascular:

• At least 3 months since myocardial infarction
• No congestive heart failure, tachydysrhythmia, or unstable angina pectoris

Other:

• Not pregnant or nursing
• Negative pregnancy test
• No active infection
• No other serious illness or medical condition
• No current or prior malignancy except nonmelanomatous skin cancer or carcinoma in situ of the cervix

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• No prior chemotherapy

Endocrine therapy:

• Not specified

Radiotherapy:

• At least 4 weeks since prior radiotherapy (no greater than 25% of bone marrow)

Surgery:

• Not specified