Patients who received chemotherapy directed at the present recurrence
Patients who previously participated in or are currently participating in another intervention clinical trial designed to improve adherence
Patients must not have received any prior tumor-directed therapy other than surgical intervention and corticosteroids
Individuals must not currently be participating in any other clinical trial for the treatment or prevention of cancer unless they are no longer receiving the intervention and are in the follow-up phase only; patients must also agree not to join such a trial while participating in this study
Patients requiring emergency surgical intervention that would be inappropriately delayed by FLT-PET imaging
Patients with NF1 will only be eligible if complete tumor resection is not considered to be feasible without substantial risk or morbidity* Patients may be treated on this trial without having received prior medical therapy directed at their PN* There will be no limit to number of prior myelosuppressive regimen for PN or other tumor manifestations associated with NF1 such as optic glioma* Patients who have received previous investigational agents or biologic therapy, such as tipifarnib, pirfenidone, peginterferon alfa-2b (Peg-Intron), sorafenib, imatinib, or other targeted therapies are eligible for enrollment; at least 4 weeks must have elapsed since receiving medical therapy directed at the PN; patients who received prior medical therapy for their PN must have recovered from the acute toxic effects of all prior therapy to =< grade 1 Common Terminology Criteria for Adverse Events (CTCAE) version (v)4 before entering this study* Growth factors that support platelet or white cell number or function must not have been administered within the 7 days prior to enrollment* At least 6 weeks must have elapsed prior to enrollment since the patient received any prior radiation therapy* At least 4 weeks must have elapsed since any surgeries, with evidence of good wound healing
PHASE I: Patients who anticipate the need for surgical intervention within the first three cycles (3 months), as surgical intervention during the period of dose limiting toxicity (DLT) evaluation may affect analysis of adherence and/or make the subject inevaluable
Patients receiving corticosteroids are eligible for this trial
Patients with radiographic ascites that is apparent on physical exam or requiring medical intervention (medication or procedures) in the 2 months prior to enrollment
Patients who have received prior anti-PD1 directed therapy (monoclonal antibody [mAb] or small molecule) are not eligible
Patients must be registered to the study within 3 working days after being seen by surgical team for MBO or within 3 working days after completion of indicated treatment (e.g. total parenteral nutrition [TPN], anticoagulation reversal) to make them eligible for surgical intervention, whichever is later, and prior to any treatment (surgical or non-surgical) for MBO; treatment is defined as any medication or invasive interventions beyond nasogastric decompression, hydration, pain medications or antiemetic medications; NOTE: somatostatin analogues may be used prior to registration if that use is limited to not more than the two days just prior to registration
Patients must be registered to the ALCHEMIST-SCREEN (ALLIANCE A151216) trial prior to randomization
Participation to a study involving a medical or therapeutic intervention in the last 30 days
More than 2 lines of therapy beyond corticosteroids with or without calcineurin inhibitors or sirolimus
Patients must be willing to use brief courses (at least 72 hours) of steroids as directed for potential inflammatory side effects of the therapy if recommended by their treating physician
Patients with NF1 will only be eligible if complete tumor resection is not considered to be feasible without substantial risk or morbidity, or if a patient with a surgical option refuses surgery* Since there is no standard effective chemotherapy for patients with NF1 and PN, patients may be treated on this trial without having received prior medical therapy directed at their PN* Since selumetinib is not expected to cause substantial myelosuppression, there will be no limit to number of prior myelosuppressive regimen for PN or other tumor manifestations associated with NF1 such as optic glioma* Patients who have received previous investigational agents or biologic therapy, such as tipifarnib, pirfenidone, Peg-Intron, sorafenib, or other VEGFR inhibitors are eligible for enrollment* Growth factors that support platelet or white cell number or function must not have been administered within the past 7 days and are not permitted while on the study* At least 6 weeks must have elapsed prior to enrollment since the patient received any prior radiation therapy, and no prior radiation therapy should have been directed at the target PN* At least 4 weeks must have elapsed since receiving medical therapy directed at the PN* At least 4 weeks must have elapsed since any surgeries, with evidence of completed wound healing* Patients who received prior medical therapy for their PN must have recovered from the acute toxic effects of all prior therapy to =< grade 1 Common Terminology Criteria for Adverse Events version 4 (CTCAE v4) before entering this study
Treatment on another therapeutic clinical trial within 4 weeks of enrollment in this trial
Patients who are receiving other cancer directed therapy at the time of enrollment
Patients who have received prior anti-GD2 therapy, including chimeric antigen receptor (CAR) T cells directed against GD2 antigen
Prior treatment with blinatumomab or CD-directed CAR T-cell therapy
Patients must be registered to the ALCHEMIST-SCREEN (ALLIANCE A151216) trial prior to randomization
Not participating in another weight loss, physical activity or dietary intervention clinical trial; co-enrollment in some trials involving pharmacologic therapy is allowed; participants in both arms are also allowed to pursue weight loss and physical activity programs on their own, as long as these programs are not provided as part of a clinical trial
Patients must not have received any prior tumor-directed therapy other than surgical intervention and corticosteroids
All patients must use adequate contraception during participation in this trial and for 3 months following completing therapy
Patients currently enrolled in other clinical trials testing a therapeutic intervention
Since there is no standard effective chemotherapy for patients with NF1 and cutaneous neurofibromas, patients may be treated on this trial without having received prior medical therapy directed at their plexiform neurofibromas (PN)
Since selumetinib is not expected to cause substantial myelosuppression, there will be no limit to number of prior myelosuppressive regimens previously received for NF1 related; or other tumor manifestations
Patients who have received previous investigational agents or biologic therapy, such as tipifarnib, pirfenidone, Peg-intron, sorafenib, or other vascular endothelial growth factor (VEGFR) inhibitors are eligible for enrollment
At least 4 weeks must have elapsed since receiving medical therapy directed at NF1 related tumor manifestations
Patients may be treated on this trial without having received prior medical therapy directed at their GIST, patients who have had prior GIST-directed surgery may enroll provided they have measurable disease
There will be no limit to number of prior myelosuppressive regimen for GIST or other tumor manifestations associated with NF1
Patients who have received previous investigational agents or biologic therapy, such as tipifarnib, pirfenidone, Peg-Intron, sorafenib, imatinib or other targeted therapies are eligible for enrollment; at least 4 weeks must have elapsed since receiving medical therapy directed at the plexiform neurofibromas (PN) and patients who received previous GIST-directed therapy must either demonstrate progression as defined by RECIST, or be unable to tolerate their previous therapy; patients who received prior medical therapy for their PN must have recovered from the acute toxic effects of all prior therapy to =< grade 1 before entering this study
Patients who anticipate the need for surgical intervention within the first three cycles (3 months), as surgical intervention during the period of dose limiting toxicity (DLT) evaluation may affect analysis of adherence and/or make the subject inevaluable
The use of anti-convulsants is allowed, as long as the patient is on a stable dose with no seizure activity for at least 2 weeks prior to initiating trial therapy
The use of corticosteroids to control cerebral edema or treat neurologic symptoms will not be allowed, and patients who previously required corticosteroids for symptom control must be off steroids for at least 3 days without recurrence of symptoms prior to starting trial therapy; corticosteroids for other indications is allowed