Sunitinib in Treating Patients With Metastatic Germ Cell Tumors That Have Relapsed or Not Responded to Treatment

DISEASE CHARACTERISTICS:

• Histologically confirmed seminoma or nonseminoma germ cell tumors (GCT)

  • Refractory or relapsed disease
  • Metastatic disease

• Progressive disease after prior cisplatin-based chemotherapy AND meets 1 of the following criteria for salvage therapy:

  • Not a candidate for potentially curative therapy
  • Received prior high-dose chemotherapy regimens
  • Declines potentially curative therapy (mediastinal GCT or primary refractory GCT)

• Measurable disease*, defined as 1 of the following:

  • At least 1 unidimensionally measurable lesion ≥ 20 mm by conventional techniques OR ≥ 10 mm by spiral CT scan
  • Elevation of alpha-fetoprotein > 15 ng/mL and/or elevation of human chorionic gonadotropin > 2.2 mIU/L
• NOTE: *Patients with radiographically measurable disease only must have ≥ 1 site that has not undergone prior irradiation

PATIENT CHARACTERISTICS:

• Karnofsky performance status 70-100%
• Absolute neutrophil count ≥ 1,500/mm³
• Platelet count ≥ 100,000/mm³
• Hemoglobin ≥ 9.0 g/dL
• Creatinine ≤ 1.5 times upper limit of normal (ULN)
• Bilirubin ≤ 1.5 times ULN
• AST and ALT ≤ 2.5 times ULN (unless elevated liver function abnormalities due to underlying malignancy)
• LVEF ≥ 50% by MUGA
• No grade 3 hemorrhage within the past 4 weeks

• None of the following within the past 6 months:

  • Myocardial infarction
  • Severe or unstable angina
  • Coronary or peripheral artery bypass graft
  • Symptomatic congestive heart failure
  • Cerebrovascular accident or transient ischemic attack
  • Pulmonary embolism
• No prolonged QTc interval (i.e., QTc > 450 msec for males and > 470 msec for females)
• No ongoing cardiac dysrhythmias ≥ grade 2
• No uncontrolled hypertension, defined as blood pressure > 150/100 mm Hg despite optimal therapy
• No active infection
• No other severe acute or chronic medical or psychiatric condition or laboratory abnormality that would preclude study compliance, according to the study investigator

• Not pregnant or nursing

  • Negative sonogram required to exclude pregnancy
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No prior sunitinib malate
• More than 4 weeks since prior major surgery and recovered
• More than 4 weeks since prior radiotherapy and recovered
• Concurrent palliative radiotherapy to metastatic lesion(s) allowed provided ≥ 1 measurable lesion has not been irradiated

• No concurrent therapeutic doses of warfarin

  • Low-dose oral warfarin (up to 2 mg daily) for prophylaxis and treatment or heparin products at prophylactic or treatment doses allowed

• No other concurrent investigational or approved anticancer therapies, including chemotherapy, biologic response modifiers, hormone therapy, or immunologic-based treatment

  • Concurrent participation in supportive care or nontreatment trials (e.g., quality-of-life or laboratory analyses) allowed