Decitabine in Treating Patients With Metastatic Papillary Thyroid Cancer or Follicular Thyroid Cancer Unresponsive to Iodine I 131

Inclusion Criteria:

• Histologically confirmed papillary thyroid or follicular thyroid carcinoma:

  • Differentiated disease;

    • Metastatic disease documented by ultrasound, computed tomography (CT) scan (without iodinated contrast), or MRI - All metastatic disease foci =< 10 mm in all dimensions
• Must have been treated with total or near-total thyroidectomy AND at least 1 course of iodine I 131 (131I)(>=29.9 mCi) OR demonstrated negative uptake on a postoperative low-dose131I scan

• Must have undergone whole body 131I scan 1-3 days after administration of =< 5.5 mCi of 131I demonstrating no visible iodine uptake within the lesions unless demonstrated negative uptake on a postoperative low-dose131I scan within the past 12 weeks:

  • Must have 24-hour urine iodine excretion =< 500 mcg within 1 week of 131I scan
• Must be receiving thyroid hormone therapy AND have thyroid-stimulating hormone level =< 0.5 mU/L
• No known brain metastases

• Performance status:

  • Eastern Cooperative Oncology Group (ECOG) 0-2 OR Karnofsky 60-100%

• Hematopoietic:

  • Absolute neutrophil count >= 1,500/mm3;
  • Platelet count >= 100,000/mm3;
  • White Blood Count (WBC) >= 3,000/mm3

• Hepatic:

  • aspartate aminotransferase-alanine aminotransferase (AST and ALT) =< 2.5 times upper limit of normal;
  • Bilirubin normal

• Renal:

  • Creatinine not elevated OR
  • Creatinine clearance >= 60 mL/min

• Cardiovascular:

  • No symptomatic congestive heart failure;
  • No unstable angina pectoris;
  • No cardiac arrhythmia
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No prior allergic reaction attributed to compounds of similar chemical or biological composition to decitabine
• No concurrent uncontrolled illness
• No active or ongoing infection
• No psychiatric illness or social situation that would preclude study compliance
• No prior cytotoxic chemotherapy for thyroid cancer
• At least 6 months since prior external beam radiotherapy administered for locoregional disease in the thyroid bed or to the cervical or upper mediastinal lymph node regions (no more than 6,000 cGy)
• More than 6 months since other prior radiotherapy and recovered
• More than 6 months since prior therapeutic 131I > 10 mCi
• More than 18 months since prior cumulative 131I activity of at least 500 mCi
• More than 12 months since prior amiodarone (Unless 24-hour urinary iodine excretion is =< 500 mcg)
• No concurrent combination antiretroviral therapy for HIV-positive patients
• No other concurrent anticancer therapy
• No other concurrent investigational agents
• More than 6 months since prior intrathecal iodinated contrast (Unless 24-hour urinary iodine excretion is =< 500 mcg)
• More than 3 months since prior IV or oral iodinated contrast for radiographic studies (Unless 24-hour urinary iodine excretion is =< 500 mcg)