Combretastatin A4 Phosphate in Treating Patients With Advanced Anaplastic Thyroid Cancer

DISEASE CHARACTERISTICS:

* Histologically confirmed\* anaplastic or poorly differentiated variant thyroid cancer, including 1 of the following:

  * Recurrent/regionally advanced disease no longer amenable to definitive curative surgery or radiotherapy
  * Untreated metastatic disease NOTE: \*If original/diagnostic tumor blocks are unavailable, tumor must be accessible for pretreatment core needle biopsy
* Must have relapsed or progressed during or after prior combined modality therapy (e.g., systemic chemotherapy and radiotherapy) for regionally advanced (but not metastatic) disease
* Measurable or evaluable disease
* Patent trachea and airway by screening direct and indirect laryngoscopy\* NOTE: \*For patients with bulky thyroid/neck masses and/or suspected airway obstruction
* No active brain metastases, as evidenced by any of the following:

  * Symptomatic involvement
  * Cerebral edema by CT scan or MRI
  * Radiographic evidence of progression since definitive therapy
  * Continued requirement for corticosteroids

PATIENT CHARACTERISTICS:

Age

* 18 and over

Performance status

* ECOG 0-2

Life expectancy

* At least 12 weeks

Hematopoietic

* Absolute granulocyte count at least 1,500/mm\^3
* Platelet count at least 75,000/mm\^3
* Hemoglobin at least 8.5 g/dL

Hepatic

* Bilirubin no greater than 1.5 times upper limit of normal (ULN)
* ALT and AST no greater than 3.5 times ULN

Renal

* Creatinine no greater than 1.5 times ULN

Cardiovascular

* LVEF at least 50% by MUGA
* EKG normal

  * No evidence of prior myocardial infarction (e.g., significant Q waves), QTc greater than 450 msec, or other clinically significant abnormalities
* No history of angina (even if controlled by medication)
* No congestive heart failure
* No uncontrolled atrial arrhythmias
* No clinically significant arrhythmias, including any of the following:

  * Conduction abnormalities
  * Nodal junctional arrhythmias and dysrhythmias
  * Sinus bradycardia or tachycardia
  * Supraventricular arrhythmias
  * Atrial fibrillation or flutter
  * Syncope or vasovagal episodes
* No significant heart wall abnormality or heart muscle damage by MUGA
* No uncontrolled hypertension (blood pressure consistently greater than 150 mm Hg systolic and 100 mm Hg diastolic regardless of medication)

  * Patients with previous hypertension are allowed provided there is clinical documentation of controlled blood pressure for 2 months prior to study enrollment
* No symptomatic peripheral vascular disease
* No symptomatic cerebrovascular disease

Other

* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No grade 2 or greater preexisting motor or sensory peripheral neuropathy
* No uncontrolled hypokalemia or hypomagnesemia
* No concurrent serious infection
* No other nonmalignant medical illness that is uncontrolled or whose control may be jeopardized by study therapy
* No psychiatric disorders or other conditions that would preclude study compliance

PRIOR CONCURRENT THERAPY:

Biologic therapy

* No concurrent biologic therapy
* No concurrent immunotherapy
* No concurrent prophylactic colony-stimulating factors (e.g., filgrastim \[G-CSF\] or sargramostim \[GM-CSF\])

Chemotherapy

* See Disease Characteristics
* At least 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin)
* No other concurrent chemotherapy

Endocrine therapy

* See Disease Characteristics
* No concurrent hormonal therapy, except any of the following:

  * Gonadotropin-releasing hormone agonists for hormone-refractory prostate cancer
  * Hormone replacement therapy
  * Oral contraceptives
  * Megestrol for anorexia/cachexia

Radiotherapy

* See Disease Characteristics
* More than 4 weeks since prior radiotherapy with progressive disease beyond radiation ports
* No prior radiotherapy to more than 30% of the bone marrow
* No concurrent radiotherapy

Surgery

* See Disease Characteristics
* More than 4 weeks since prior major surgery

Other

* At least 6 weeks since other prior therapy associated with delayed toxicity
* No prior therapy for metastatic disease
* No concurrent medication(s) known to prolong the QTc interval, unless medication(s) can be held for at least 72 hours before, during, and for at least 6 hours after study drug administration
* No other concurrent investigational therapy
* No other concurrent antineoplastic or cytotoxic therapy