PHASE I STUDY OF CONCOMITANT PEMETREXED AND CDDP PLUS RADIATION THERAPY IN PATIENTS WITH LOCALLY ADVANCED OR METASTATIC ESOPHAGEAL OR GASTROESOPHAGEAL (GEJ) CARCINOMAS

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Diagnosis of esophageal or gastroesophageal junction carcinoma

- Stage III or IV disease

- Treatment with chemoradiotherapy is considered appropriate

- Measurable or evaluable disease

- Clinically significant pleural or pericardial effusions or ascites allowed provided
they were drained prior to study entry

- No pleurodesis within the past 2 weeks

- Controlled brain metastasis allowed provided patient is clinically stable with no
signs of progression by MRI or CT scan of the brain ≥ 60 days after completion of
treatment AND is asymptomatic and does not require steroids

PATIENT CHARACTERISTICS:

- ECOG performance status 0-2

- Life expectancy ≥ 12 weeks

- WBC ≥ 2,500/mm^3

- ANC ≥ 1,500/mm^3

- Hemoglobin ≥ 9 g/dL

- Platelet count ≥ 100,000/mm^3

- Total bilirubin normal

- Alkaline phosphatase AND AST and ALT meeting the following criteria:

- Alkaline phosphatase normal AND AST or ALT ≤ 3 times upper limit of normal (ULN)
(≤ 5 times ULN for patients with liver metastases)

- Alkaline phosphatase ≤ 2.5 times ULN AND AST or ALT ≤ 1.5 times ULN

- Alkaline phosphatase ≤ 5 times ULN AND AST or ALT normal

- Creatinine clearance ≥ 45 mL/min

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception during and for 3 months after
completion of study therapy

- Able to take folic acid, vitamin B_12, or corticosteroids

- No known severe hypersensitivity reaction to study drugs

- No uncontrolled serious active infection

- No pre-existing peripheral neuropathy > grade 1

- No significant cardiac disease, including any of the following:

- Uncontrolled high blood pressure

- Unstable angina

- Congestive heart failure within the past 6 months

- Left ventricular ejection fraction below the lower limit of normal

- Myocardial infarction within the past year

- Serious cardiac arrhythmias requiring medication

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- No prior systemic therapy regimens

- No prior radiotherapy to gastric/esophageal fields

- No aspirin or other NSAID before and after pemetrexed disodium administration

- No concurrent colony-stimulating factors (CSF) to maintain WBC and ANC eligibility
values