Chemotherapy before Surgery in Treating Patients with High Grade Upper Urinary Tract Cancer

Inclusion Criteria

• Patients must have high grade upper tract urothelial carcinoma proven by one of the following: * Biopsy; * Urinary cytology with a 3-dimensional upper urinary tract mass on cross-sectional imaging; or * Urinary cytology and a mass visualized during upper urinary tract endoscopy
• Patients must have a creatinine clearance >= 30 ml/min within 28 days of registration to be eligible for the study; this will be determined by Cockroft-Gault calculation and 24-hour urine creatinine clearance measurement (please note, renal function, measured by 24-hour urine creatinine clearance in screening and post operatively, are required)
• Patients must have Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
• Patients must have no evidence of metastatic disease or clinically enlarged lymph nodes on computed tomography (CT) or magnetic resonance imaging (MRI) of the abdomen and pelvis and CT chest obtained within 28 days of registration (a negative biopsy is required for lymph nodes >= 1 cm in size to confirm lack of involvement); patients with lymph nodes >= 1 cm in whom a biopsy is deemed not feasible are not eligible; patients with elevated alkaline phosphatase or suspicious bone pain should also undergo baseline bone scans to evaluate for bone metastasis
• Patients with any component of small cell carcinoma are not eligible; other variant histologies are permitted provided the predominant (>= 50%) subtype is urothelial carcinoma
• Patients must not have peripheral neuropathy > grade 2
• Patients must not have a history of allergy or hypersensitivity to methotrexate, vinblastine, doxorubicin (doxorubicin hydrochloride), cisplatin, gemcitabine (gemcitabine hydrochloride), carboplatin or filgrastim or pegfilgrastim
• Patients must have a left ventricular ejection fraction (LVEF) >= 50% by (either multigated acquisition [MUGA] or 2-dimensional [2-D] echocardiogram) within 28 days of registration
• Absolute neutrophil count (ANC) >= 1500/mm^3
• Platelets >= 100,000/mm^3
• Hemoglobin (HgB) >= 9
• Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) < 2 X institutional upper limit of normal (ULN)
• Total bilirubin within institutional normal limits (or < 2.5 X the ULN for patients with Gilbert’s disease)
• Patients with concomitant primaries of the bladder/urethra are allowed, as long as these sites are surgically resected and non-invasive cancers (< cT1N0)
• Patients must not have another active second malignancy other than non-melanoma skin cancers and biochemical relapsed prostate cancer; patients that have completed all necessary therapy and are considered to be at less than 30% risk of relapse are not considered to have an active second malignancy and are eligible for enrollment
• For patients who have creatinine clearance that meets > 50 ml/min they must not have received prior systemic doxorubicin
• Patients with uncontrolled illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, myocardial infarction in last 3 months, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements are not eligible
• Patients who are known to have human immunodeficiency virus (HIV) or are on combination antiretroviral therapy are ineligible
• Patients must have no prior radiation therapy to >= 25% of the bone marrow for prior systemic anthracycline therapy; prior intravesical anthracycline therapy for non-muscle invasive urothelial carcinoma of the bladder is permitted
• Patients may have a history of resectable urothelial cancer (including neoadjuvant chemotherapy) as long as patients meet one of the following: * pT0, Tis, or T1N0 and have no evidence of disease (NED) for more than 2 years from surgery or chemotherapy; * pT2-3aN0 and NED for more than 3 years from surgery or chemotherapy; or * > pT3b, or N+ and NED for more than 5 years from surgery or chemotherapy
• Women must not be pregnant or breast-feeding; all females of childbearing potential must have a blood test or urine study within 2 weeks prior to registration to rule out pregnancy; a female of childbearing potential is any woman, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
• Women of childbearing potential and sexually active males must use an accepted and effective method of contraception or to abstain from sexual intercourse for the duration of their participation in the study