Paclitaxel and Carboplatin or Bleomycin Sulfate, Etoposide Phosphate, and Cisplatin in Treating Patients With Advanced or Recurrent Sex Cord-Ovarian Stromal Tumors

DISEASE CHARACTERISTICS:

• Histologically confirmed ovarian stromal tumor, including the following cell types:

  • Granulosa cell tumor
  • Granulosa cell-theca cell tumor
  • Sertoli-Leydig cell tumor (androblastoma)
  • Steroid (lipid) cell tumor
  • Gynandroblastoma
  • Unclassified sex cord-stromal tumor
  • Sex cord tumor with annular tubules

• Meets 1 of the following criteria:

  • Newly diagnosed, stage IIA-IVB disease

    • Has undergone initial surgery (for diagnosis, staging, or cytoreduction) within the past 8 weeks
    • May or may not have measurable residual disease

  • Biopsy-proven recurrent disease of any stage

    • Chemotherapy-naive disease

• Patients with measurable disease must have ≥ 1 "target lesion" to be used to assess response

  • Tumors within a previously irradiated field will be designated as "non-target" lesions unless progression is documented or a biopsy is obtained to confirm persistence ≥ 90 days following completion of radiotherapy

PATIENT CHARACTERISTICS:

• GOG performance status 0-2
• ANC ≥ 1,500/mm^3
• Platelet count ≥ 100,000/mm^3
• Creatinine normal
• Bilirubin ≤ 1.5 times ULN
• SGOT ≤ 3.0 times ULN
• Alkaline phosphatase ≤ 2.5 times ULN
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

• Pulmonary function sufficient to receive bleomycin sulfate, as indicated by the following:

  • Normal lung expansion
  • Absence of crackles on auscultation
  • Normal DLCO, defined as > 80% predicted
• History of hypersensitivity reactions to chemotherapy administered for a prior cancer diagnosis allowed, unless the hypersensitivity reaction consisted of anaphylaxis not amenable to desensitization
• No peripheral neuropathy > grade 1
• No signs of clinically significant hearing loss
• No other invasive malignancies within the past 5 years except for curatively treated nonmelanoma skin cancer
• No other medical history or condition that, in the opinion of the investigator, would preclude study participation

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• Recovered from recent surgery, radiotherapy, or chemotherapy
• No prior cytotoxic chemotherapy or biologic therapy for sex cord-stromal tumors
• At least 1 week since prior hormonal therapy directed at the malignant tumor

• No other concurrent antineoplastic therapy, including cytotoxic therapy, biologic therapy, hormonal therapy, or radiotherapy

  • Concurrent hormone replacement therapy allowed