Sunitinib Malate and Combination Chemotherapy as Front-Line Therapy in Treating Patients With Metastatic Rectal Cancer That Cannot Be Removed by Surgery

DISEASE CHARACTERISTICS:

* Histologically confirmed adenocarcinoma of the rectum

  * Lower pole of the tumor \< 12 cm from the anal margin
* Synchronous metastases of the liver and/or lung

  * Unresectable or resectability uncertain according to the decision of a local multidisciplinary consultation
* Lesions measurable in 1 dimension by RECIST criteria (metastases and primary rectal cancer)
* No rectal obstruction requiring surgery or the emergency fitting of a prosthesis
* No CNS metastases

PATIENT CHARACTERISTICS:

* WHO performance status 0-2
* ANC ≥ 1,500/mm\^3
* Platelet count ≥ 100,000/mm\^3
* Creatinine clearance ≥ 60 mL/min
* Hemoglobin ≥ 10 g/dL (transfusions allowed)
* FEV ≥ 50%
* QT interval ≤ 450 ms (in men) or ≤ 470 ms (in women)
* Total bilirubin ≤ 1.5 times upper limit of normal
* Serum albumin ≥ 25 g/L
* Not pregnant or nursing
* Fertile patients must use effective contraception
* No history of another cancer except for nonmelanoma skin cancer or curatively treated carcinoma in situ of the cervix

  * History of other cancers allowed provided the patient has been disease-free \> 3 years
* None of the following:

  * Congestive heart failure or coronary heart disease
  * Myocardial infarction within the past year
  * Uncontrolled hypertension (systolic BP \> 160 mm Hg or diastolic BP \> 100 mm Hg) despite optimal medical management
* No active severe rectal bleeding
* No liver failure
* No known Gilbert syndrome
* No severe uncontrolled infection
* No chronic diarrhea, malabsorption syndrome, or intestinal obstruction/subocclusion
* No severe uncontrolled pain (visual analogue scale 5/10) with morphine treatment
* No other medical, psychological, or social condition that, in the investigator's opinion, could affect the patient's compliance with study treatment
* No hypersensitivity to any component of study treatment

PRIOR CONCURRENT THERAPY:

* See Patient Characteristics
* No prior radiotherapy to the pelvis
* More than 4 weeks since prior experimental therapy
* More than 7 days since prior CYP3A4 inhibitor before the administration of sunitinib malate
* More than 12 days since prior CYP3A4 inducer
* No concurrent participation in another clinical study
* No other concurrent anticancer therapy