Clinical Research Directory

DISEASE CHARACTERISTICS: * Diagnosis of neuroblastoma either by histological confirmation and/or demonstration of tumor cells in the bone marrow with increased urinary catecholamines * Differentiating ganglioneuroblastoma allowed * No histological evidence only of ganglioneuroma by tumor biopsy or bone marrow biopsy * High-risk disease meeting at least one of the following criteria: * Recurrent/progressive disease at any time * Refractory disease (i.e., less than a partial response to front-line therapy that included ≥ 4 courses of chemotherapy) * Persistent disease after at least a partial response to front-line therapy (i.e., still has residual disease by MIBG, CT/MRI, or bone marrow biopsy) * Biopsy of at least one residual site demonstrating viable neuroblastoma required (tumor by bone marrow morphology is considered adequate documentation of disease) * Measurable disease meeting at least one of the following criteria: * Measurable tumor on MRI or CT scan, defined as at least one unidimensionally measurable lesion ≥ 20 mm by conventional techniques or ≥ 10 mm by spiral CT scan * For patients with persistent disease, a biopsy\* of bone marrow or bone or soft tissue site must have demonstrated viable neuroblastoma * MIBG scan with positive uptake at a minimum of one site * For patients with persistent disease, a biopsy\* of a MIBG positive site must have demonstrated viable neuroblastoma * Bone marrow with tumor cells seen on routine morphology (not by NSE staining only) of bilateral aspirate and/or biopsy of one bone marrow sample NOTE: \*If the lesion was irradiated, the biopsy must have been done at least 4 weeks after completion of radiotherapy * No CNS parenchymal or meningeal-based lesions * Skull-based tumor lesions with or without intracranial extension are allowed provided there are no neurologic signs or symptoms or hydrocephalus related to the lesion * Patients with a history of complete surgical resection of CNS lesions are eligible provided there is no evidence of CNS lesions by MRI or CT scan at study entry * Patients with a history of CNS lesions must be off corticosteroid therapy for CNS lesions for ≥ 4 weeks PATIENT CHARACTERISTICS: * Performance status 0-2 * Life expectancy ≥ 2 months * ANC ≥ 500/mm³ * Platelet count ≥ 50,000/mm³ (transfusion independent) * Hemoglobin ≥ 8.0 g/dL (transfusion independent) * Serum creatinine ≤ 1.5 times normal for age * Total bilirubin ≤ 1.5 times normal for age * ALT and AST ≤ 3 times normal for age * Serum triglycerides \< 300 mg/dL * Serum calcium \< 11.6 mg/dL * Lipase normal for age * PT/PTT ≤ 1.5 times upper limit of normal for age (without fresh frozen plasma support; vitamin K allowed) * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception prior to, during, and for 2 months after completion of study treatment * LVEF ≥ 55% by ECHO or MUGA scan OR fractional shortening ≥ 27% by ECHO * No EKG abnormality * No dyspnea at rest or requirement for oxygen * No hematuria and/or proteinuria \> 1+ on urinalysis * No known history of allergy to egg products * No known history of allergy to soy bean oil * No skin toxicity \> grade 1 per CTCAE v3 * Seizure disorder allowed if seizures are controlled on anticonvulsants and the anticonvulsant(s) is not contraindicated * Known genetic, metabolic, or psychiatric conditions, or other ongoing serious medical issues must be approved by the study chair prior to study registration PRIOR CONCURRENT THERAPY: * Recovered from all prior chemotherapy, immunotherapy, or radiotherapy * More than 3 weeks since prior myelosuppressive chemotherapy (4 weeks for nitrosoureas) and/or biologic therapy without stem cell support * More than 7 days since prior hematopoietic growth factors * No prior radiotherapy to the only site of measurable disease unless there has been subsequent disease progression at that site or a biopsy of that site showed viable neuroblastoma ≥ 4 weeks after completion of radiotherapy * Prior CNS irradiation allowed * At least 2 weeks since prior small field (focal) radiotherapy * At least 6 weeks since prior large field radiotherapy (i.e., total-body irradiation, craniospinal radiotherapy, whole abdominal or total lung radiotherapy, or radiotherapy to \> 50% of marrow space) * At least 56 days since prior myeloablative autologous stem cell transplantation * At least 4 weeks since prior myelosuppressive therapy with stem cell support * At least 6 weeks since prior MIBG therapy * Prior oral fenretinide therapy allowed * At least 3 weeks since prior retinoid therapies * No prior organ transplantation * No prior myeloablative allogeneic stem cell transplantation unless stem cells were from an identical twin sibling * No concurrent systemic corticosteroids, including corticosteroids for emesis control * Concurrent inhaled corticosteroids for asthma control or steroids for metabolic deficiency states allowed * Concurrent palliative radiotherapy allowed provided the irradiated sites will not be used to measure response * No concurrent parenteral intralipids * No other concurrent chemotherapy or immunomodulating agents * No concurrent drugs suspected of causing pseudotumor cerebri, including tetracycline, nalidixic acid, nitrofurantoin, phenytoin, sulfonamides, lithium, or amiodarone * No concurrent vitamin A, C, or E supplements (except as part of routine total parenteral nutrition \[TPN\] supplements or as part of a single daily standard dose of oral multivitamin supplement) * No concurrent medications that may potentially act as modulators of intracellular ceramide levels or ceramide cytotoxicity, sphingolipid transport, or p-glycoprotein (MDR1) or MDR1 drug/lipid transporters, including cyclosporine or analogue, verapamil, tamoxifen or analogue, ketoconazole, chlorpromazine, mifepristone (RU486), indomethacin, or sulfinpyrazone * No other concurrent anticancer agents * No concurrent herbal supplements or other alternative therapy medications * No concurrent anti-arrhythmia or inotropic cardiac medications