Phase II Trial of Combined Modality Combretastatin A-4 Phosphate (CA4P)-Based Therapy for Patients With Newly Diagnosed Anaplastic Thyroid Cancer [Induction Chemotherapy With Doxorubicin/Cisplatin; Combined Modality Therapy With CA4P and Radiation; Followed by 2 Cycles of CA4P Consolidation]

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Histologically confirmed anaplastic or poorly differentiated variant thyroid
carcinoma of either of the following:

- Regionally advanced disease

- Confined to the neck and/or superior mediastinum (i.e., above the level of
the carina)

- Measurable or evaluable* disease

- Completely resected disease without measurable or evaluable disease NOTE: *At a
minimum, abnormalities on physical exam or radiographic studies that may not be
precisely measured but readily followed

- Must have original/diagnostic tumor blocks available to confirm histopathology and
for tumor microvessel density immunohistochemistry

- Patients with no available original/diagnostic tumor blocks must have tumor
accessible for pretreatment needle core biopsy

- Must undergo indirect and direct laryngoscopy to ensure patency of the trachea/airway
if deemed inoperable, with bulky thyroid/neck masses and/or suspicion of airway
obstruction

- No distant metastases, including but not limited to, brain metastases, disease below
the level of the carina, pulmonary parenchyma, and hepatic or bony metastases

- Superior mediastinal disease (i.e., above the level of the carina) in addition
to regional neck disease is allowed provided the disease can be contained in a
single radiotherapy port

PATIENT CHARACTERISTICS:

Age

- 18 and over

Performance status

- ECOG 0-2

Life expectancy

- At least 12 weeks

Hematopoietic

- Absolute granulocyte count ≥ 1,500/mm^3

- Platelet count ≥ 75,000/mm^3

- Hemoglobin ≥ 8.5 g/dL

Hepatic

- Bilirubin ≤ 1.5 mg/dL

- ALT and AST ≤ 3.5 times upper limit of normal

Renal

- Creatinine ≤ 1.5 mg/dL

Cardiovascular

- LVEF ≥ 50% by echocardiogram

- EKG normal

- No prior angina

- No prior myocardial infarction (e.g., significant Q waves), QTc > 450 msec, or other
clinically significant abnormalities on ECG

- No congestive heart failure

- No uncontrolled atrial arrhythmias or clinically significant arrhythmias, including
any of the following:

- Conduction abnormality

- Nodal junctional arrhythmias and dysrhythmias

- Sinus bradycardia or tachycardia

- Supraventricular arrhythmias

- Atrial fibrillation or flutter

- Syncope or vasovagal episodes

- No significant heart wall abnormality or heart muscle damage by echocardiogram

- No uncontrolled hypertension (i.e., blood pressure consistently greater than 150/100
mm Hg irrespective of medication)

- Hypertension is allowed provided there is clinical documentation of controlled
blood pressure for 2 months before study entry

- No symptomatic peripheral vascular disease or cerebrovascular disease

Other

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- No uncontrolled hypokalemia or hypomagnesemia

- No concurrent serious infection

- No other nonmalignant uncontrolled medical illness or one whose control may be
jeopardized by the complications of study therapy

- No grade 2 or greater pre-existing motor or sensory peripheral neuropathy

- No psychiatric disorder or other condition that would preclude study compliance

- No conditions associated with QTc prolongation

PRIOR CONCURRENT THERAPY:

Biologic therapy

- No concurrent biologic therapy

- No concurrent immunotherapy

Chemotherapy

- No prior chemotherapy

- No other concurrent chemotherapy

Endocrine therapy

- No concurrent hormonal therapy, except for the following:

- Gonadotropin-releasing hormone agonists for patients with hormone-refractory
prostate cancer

- Hormone replacement therapy

- Oral contraceptives

- Megestrol for anorexia/cachexia

Radiotherapy

- No prior radiotherapy

- No concurrent radiotherapy

Surgery

- See Disease Characteristics

- Prior attempt at resection or cytoreduction (e.g., debulking) surgery irrespective of
surgical margins allowed provided there are no distant metastases

- At least 1 week but no more than 8 weeks since prior surgery and recovered

Other

- No other concurrent cytotoxic therapy

- No other concurrent antineoplastic therapy

- No other concurrent investigational therapy

- No concurrent medications known to prolong the QTc interval unless the medication can
be held for at least 4 days during each treatment course