Gemcitabine Hydrochloride, Cisplatin, and Sunitinib Malate as First-Line Therapy in Treating Patients With Locally Advanced And/or Metastatic Transitional Cell Carcinoma of the Urothelium (SUCCINCT)

DISEASE CHARACTERISTICS:

* Histologically confirmed transitional cell carcinoma of the urothelium

  * Pure or mixed histology
  * Upper or lower urinary tract
* Radiologically measurable, locally advanced and/or metastatic disease not amenable to curative treatment with surgery or radiotherapy meeting 1 of the following criteria:

  * T4b (bladder) or T4 (renal pelvis/ureter), any N, any M
  * Any T, N2-3, any M
  * Any T, any N, M1
* No urothelial cancer for which subsequent radical treatment is being considered with a view to possibly cure the disease
* No history of CNS metastases

PATIENT CHARACTERISTICS:

* WHO performance status 0-2
* Life expectancy \> 3 months
* Absolute neutrophil count ≥ 1.5 x 10\^9/L
* Platelet count ≥ 100 x 10\^9/L
* Bilirubin ≤ 1.5 times upper limit of normal (ULN)
* ALT and ALP ≤ 2.5 times ULN
* GFR ≥ 60 mL/min (uncorrected for surface area and measured by isotopic means)
* PT or INR ≤ 1.5 times ULN
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* Fit to receive cisplatin-containing combination chemotherapy
* No previous malignancy other than nonmelanoma skin cancer, carcinoma in situ of the cervix, or incidental localized prostate cancer
* No known HIV positivity or chronic hepatitis B or C infection
* No uncontrolled hypertension
* No symptomatic coronary artery disease, myocardial infarction within the past 6 months, congestive cardiac failure (NYHA class III-IV disease), or uncontrolled or symptomatic cardiac arrhythmia
* No clinically significant bacterial or fungal infection
* No concurrent grapefruit juice

PRIOR CONCURRENT THERAPY:

* At least 1 month since prior radiotherapy or radiotherapy involving more than 30% of total bone marrow volume
* At least 1 month since prior investigational drug
* No prior systemic therapy for locally advanced or metastatic disease

  * Patients who have received prior neoadjuvant or adjuvant chemotherapy for urothelial cancer (up to 4 courses), completed at least 6 months prior to first documented disease progression, are eligible
* No concurrent anticoagulant therapy with warfarin or unfractionated heparin

  * Patients requiring anticoagulation may be entered on study after successful conversion to low molecular weight heparin
* No concurrent medications that have known adverse interactions with sunitinib malate (i.e., strong CYP3A4 inhibitors or inducers)
* No prior or concurrent live vaccines (e.g., measles, mumps, rubella, oral polio, bacille Calmette-Guérin \[BCG\], yellow fever, varicella, and TY21a typhoid vaccines)