Depsipeptide (Romidepsin) in Treating Patients With Metastatic or Unresectable Soft Tissue Sarcoma

Inclusion Criteria:

* Histologically or cytologically confirmed soft tissue sarcoma (STS), including, but not limited to, the following histologies:

  * Gastrointestinal stromal tumors (GIST)

    * Refractory to imatinib mesylate
  * Desmoplastic small round cell tumors
  * Clear cell sarcoma
  * Extraskeletal osteosarcoma\*
  * Extraskeletal Ewing's sarcoma\*
  * Extraskeletal (myxoid) chondrosarcoma\*
* Secondary STS (e.g., radiation-induced STS or neurofibrosarcoma due to neurofibromatosis) allowed
* Metastatic or unresectable disease
* No standard curative therapy exists
* Patients with GIST must have received and progressed on imatinib mesylate
* Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques OR ≥ 10 mm by spiral CT scan
* No known brain metastases
* Performance status - Eastern Cooperative Oncology Group (ECOG) 0-2
* Performance status - Karnofsky 50-100%
* More than 3 months
* White blood cells (WBC) ⥠3,000/mm\^3
* Absolute neutrophil count ≥ 1,500/mm\^3
* Platelet count ≥ 100,000/mm\^3
* Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ⤠2.5 times upper limit of normal (ULN)
* Bilirubin normal
* Creatinine \< 1.5 times ULN
* Creatinine clearance ≥ 60 mL/min
* QTc ≤ 480 msec

Exclusion Criteria:

* No cardiac abnormalities (e.g., congenital long QT syndrome)
* No myocardial infarction within the past year
* No history of coronary artery disease (e.g., angina Canadian Class II-IV or positive stress imaging study)
* No cardiac ischemia (ST depression \>2 mm) by electrocardiogram (ECG)
* No New York Heart Association Class II-IV congestive heart failure
* Ejection fraction \> 50% by multi gated acquisition scan (MUGA) scan or echocardiogram
* No history of sustained ventricular tachycardia, ventricular fibrillation, Torsades de Pointes, or cardiac arrest unless controlled by an automatic implantable cardioverter defibrillator
* No hypertrophic or restrictive cardiomyopathy from prior treatment or other causes
* No significant left ventricular hypertrophy
* No uncontrolled hypertension (i.e., blood pressure ≥ 160/95 mm Hg)
* No cardiac arrhythmia requiring anti-arrhythmic medication

  * Beta blocker or calcium channel blocker allowed
  * Patients on digitalis that cannot be discontinued not allowed
* No Mobitz II second degree block without a pacemaker (first degree or Mobitz I second degree block, bradyarrhythmias, or sick sinus syndrome require Holter monitoring and evaluation by cardiology)
* No uncontrolled dysrhythmia
* No poorly controlled angina
* No other cardiac disease
* No history of allergic reaction attributed to compounds of similar chemical or biological composition to FR901228
* No ongoing or active infection
* No iatrogenic immune deficiency or immune deficiency secondary to an underlying disorder
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* Potassium ≥ 4.0 mmol/L
* Magnesium ≥ 2.0 mg/dL
* No other uncontrolled illness
* No psychiatric illness or social situation that would preclude study compliance
* No concurrent anticancer biologic agents
* No more than 1 prior chemotherapy regimen for sarcoma

  * Adjuvant chemotherapy preceding disease relapse is considered 1 prior chemotherapy regimen
  * Patients with GIST may have received up to 3 prior chemotherapy regimens comprising imatinib mesylate and/or sunitinib malate provided no other chemotherapy agents were used
* No prior FR901228 (depsipeptide)
* At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin)
* No prior cumulative doxorubicin dose \> 500 mg/m\^2
* No other concurrent anticancer chemotherapy
* At least 4 weeks since prior radiotherapy
* No concurrent anticancer radiotherapy
* At least 4 weeks since prior surgery
* No prior organ transplantation
* Recovered from all prior therapy
* No concurrent medications that cause QTc prolongation
* No concurrent combination highly active anti-retroviral therapy for HIV-positive patients
* No other concurrent drugs known to have histone deacetylase inhibitor activity (e.g., sodium valproate)
* No other concurrent investigational agents
* No other concurrent anticancer agents