Oxaliplatin, Gefitinib, and Radiation Therapy in Treating Patients With Locally Advanced or Metastatic Esophageal Cancer

DISEASE CHARACTERISTICS:

• Histologically confirmed adenocarcinoma or squamous cell carcinoma of the esophagus or gastroesophageal (GE) junction

  • Locally advanced or metastatic disease by clinical staging, including esophagogastroduodenoscopy and esophageal ultrasound

    • Stage T2, N0 disease and beyond

  • Bulk of tumor must be in the esophagus of patients with GE junction tumor

    • Bronchoscopy is required if primary esophageal tumor is < 26 cm from the incisors
• No brain metastases

PATIENT CHARACTERISTICS:

Age

• Over 18

Performance status

• ECOG 0-1

Life expectancy

• At least 4 months

Hematopoietic

• WBC ≥ 3,000/mm^3
• Granulocyte count ≥ 1,500/mm^3
• Platelet count > 100,000/mm^3

Hepatic

• Bilirubin normal
• ALT and AST ≤ 2.5 times upper limit of normal (ULN)
• Alkaline phosphatase ≤ 2.5 times ULN

Renal

• Not specified

Cardiovascular

• No symptomatic congestive heart failure
• No unstable angina pectoris
• No cardiac arrhythmia

Pulmonary

• No clinically active interstitial lung disease

  • Patients with chronic stable asymptomatic radiographic changes are eligible

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective double-method (including barrier) contraception during and for 3 months after study participation
• No peripheral neuropathy ≥ grade II
• No severe hypersensitivity to gefitinib or any of its excipients
• No history of allergy to platinum-based compounds or antiemetics administered with protocol-directed chemotherapy
• No active or ongoing infection
• No other uncontrolled illness
• No other significant clinical disorder or laboratory finding that would preclude study participation

PRIOR CONCURRENT THERAPY:

Biologic therapy

• No concurrent colony-stimulating factors during course 1 of study therapy

Chemotherapy

• More than 4 weeks since prior chemotherapy

Endocrine therapy

• Concurrent steroid therapy allowed

Radiotherapy

• More than 4 weeks since prior radiotherapy

Surgery

• Not specified

Other

• More than 30 days since prior non-approved or investigational drugs

• No concurrent administration of any of the following:

  • Phenytoin
  • Carbamazepine
  • Rifampin
  • Barbiturates
  • Highly-active antiretroviral therapy (HAART)
  • Hypericum perforatum (St. John's wort)
• No other concurrent investigational agents or therapy