Aflibercept in Treating Young Patients With Relapsed or Refractory Solid Tumors

Inclusion Criteria:

* Histologically confirmed malignancy at original diagnosis or relapse (excluding intrinsic brain stem tumors, optic pathway gliomas, or patients with pineal tumors and elevations of serum alpha-fetoprotein of beta-HCG)

  * Patients with recurrent or refractory solid tumors are eligible, including primary CNS tumors or patients with known CNS metastases
* Current disease state must be one for which there is no known curative therapy or therapy proven to prolong survival with an acceptable quality of life
* Measurable or evaluable disease
* No evidence of CNS hemorrhage on baseline MRI for patients with known CNS disease
* Karnofsky performance status (PS) 50-100% (for patients \> 10 years of age) or Lansky PS 50-100% (for patients ≤ 10 years of age)

  * Neurologic deficits in patients with CNS tumors must have been relatively stable for a minimum of 1 week prior to study entry
  * Patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score
* Patients with solid tumors without bone marrow involvement must meet the following criteria:

  * ANC ≥ 1,000/mm³
  * Platelet count ≥ 100,000/mm³ (transfusion independent, defined as not receiving platelet transfusions within a 7 day period prior to enrollment)
  * Hemoglobin ≥ 8.0 g/dL (may receive RBC transfusions)
* Negative protein dipstick OR urine protein \< 500 mg by 24-hour urine collection
* Creatinine clearance or radioisotope glomerular filtration rate ≥ 70 mL/min OR serum creatinine based on age/gender as follows:

  * 0.6 mg/dL for male and female patients 1 to \< 2 years of age
  * 0.8 mg/dL for male and female patients 2 to \< 6 years of age
  * 1.0 mg/dL for male and female patients 6 to \< 10 years of age
  * 1.2 mg/dL for male and female patients 10 to \< 13 years of age
  * 1.5 mg/dL (male) or 1.4 mg/dL (female) for patients 13 to \< 16 years of age
  * 1.7 mg/dL (male) or 1.4 mg/dL (female) for patients ≥ 16 years of age
* Bilirubin ≤ 1.5 times upper limit of normal (U.N.) for age
* SEPT (ALT) ≤ 110 μ/L (approx. 2.5 times U.N.) (for the purpose of this study, the U.N. for SEPT is 45 μ/L)
* Serum albumin ≥ 2 g/dL
* PT/aPTT \< 1.2 times U.N.
* Patients must have a diastolic blood pressure ≤ the 95th percentile for age and gender and not be receiving treatment for hypertension
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No evidence of active graft-vs-host disease
* No uncontrolled infection
* No serious or nonhealing wound, ulcer, or bone fracture
* No history of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 4 weeks prior to day 1 of study treatment
* No clinically significant cardiovascular disease within the past 6 months, including any of the following:

  * History of cerebrovascular accident
  * New York Heart Association class III-IV congestive heart failure
  * Serious cardiac arrhythmia requiring medication
  * Unstable angina pectoris
  * Pulmonary embolism
  * Deep vein thrombosis
  * Other thromboembolic events
* No evidence of a current bleeding diathesis or coagulopathy
* No known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies
* No history of allergic reactions attributed to compounds of similar chemical or biologic composition to other agents used in the study
* No significant traumatic injury within 4 weeks prior to day 1 of study treatment
* Must be able to comply with the safety monitoring requirements of the study in the opinion of the investigator
* Recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy
* No prior aflibercept
* At least 3 weeks since prior myelosuppressive chemotherapy (6 weeks for nitrosourea)
* At least 6 weeks since prior monoclonal antibodies
* At least 2 weeks since prior local palliative radiotherapy (small port)
* At least 6 weeks since other prior substantial bone marrow radiotherapy
* At least 2 months since prior stem cell transplantation or rescue
* At least 3 months since prior total-body irradiation, craniospinal radiotherapy, or radiotherapy to ≥ 50% of the pelvis
* At least 4 weeks since prior major surgical procedure, laparoscopic procedure, or open biopsy and no anticipation of need for major surgical procedures during the course of the study
* At least 48 hours since prior fine needle aspirate, central line placement, or subcutaneous port placement
* At least 1 week since prior core biopsy
* At least 1 week since prior and no concurrent hematopoietic growth factors
* At least 1 week since prior and no concurrent biologic agents
* At least 1 week since prior and no concurrent dexamethasone
* No concurrent antihypertensive medications for blood pressure control
* No concurrent anti-thrombotic or anti-platelet agents (e.g., warfarin \[Coumadin ®\],heparin, low molecular weight heparin, aspirin, and/or ibuprofen, or other NSAIDs)
* No concurrent medications known to inhibit platelet function or known to selectively inhibit cyclooxygenase-2 activity (e.g., all antipyretic and anti-inflammatory medications except acetaminophen)
* No other concurrent anticancer therapy, including chemotherapy, radiotherapy, immunotherapy, or biologic therapy
* No other concurrent investigational drugs