Bevacizumab and Oxaliplatin Combined With Irinotecan or Leucovorin and Fluorouracil in Treating Patients With Metastatic or Recurrent Colorectal Cancer

You may be eligible if

• INCLUSION:
• Metastatic or locally recurrent colorectal adenocarcinoma
• Measurable disease
• At least 2 formalin-fixed paraffin embedded core needle biopsies OR fine needle aspirate containing a minimum of 3 clusters of malignant cells and fixed tissue from the previous biopsy
• If no tissue samples are available the patient must be willing to undergo biopsy of a metastatic site
• Age 18 and over
• Eastern Cooperative Oncology Group (ECOG) Performance status 0-2
• Absolute neutrophil count ≥ 1,500/mm\^3
• Platelet count ≥ 100,000/mm\^3
• Prothrombin time (PT)/international normalized ratio (INR) ≤ 1.5 unless patient is receiving full-dose anticoagulants AND the following criteria are met:
• * In-range INR (usually between 2 and 3) AND on a stable dose of warfarin or low molecular weight heparin
• * No active bleeding or pathological condition that is associated with a high risk of bleeding
• Partial thromboplastin time (PTT) \< 1.5 times upper limit of normal (ULN)
• Alanine transaminase (ALT) and aspartate aminotransferase (AST) \< 3 times ULN
• Bilirubin ≤ 1.5 times ULN
• Creatinine ≤ 1.8 mg/dL
• Meets 1 of the following criteria:
• * Protein negative on urine dipstick
• * Urine protein/creatinine ratio \< 1.0
• * Less than 2 g protein on 24-hour urine collection
• Patients with a history of hypertension must meet the following criteria:
• * Blood pressure \< 150/90 mm Hg
• * Stable regimen of anti-hypertensive therapy
• More than 28 days since prior major or open surgery
• Negative pregnancy test
• Fertile patients must use effective contraception during and for 3 months after study participation
• Prior non-colorectal malignancies are allowed provided the following criteria are met:
• * No current clinical evidence of persistent or recurrent disease
• * No active therapy for non-colorectal malignancy, including hormonal therapy
• EXCLUSION:
• Pregnant or nursing
• Arterial thromboembolic events within the past 6 months, including the following:
• * Transient ischemic attack
• * Cerebrovascular accident
• * Unstable angina pectoris
• * Myocardial infarction
• Symptomatic arrhythmia
• Symptomatic congestive heart failure
• Clinically significant peripheral artery disease
• New York Heart Association class III or IV heart disease
• Serious nonhealing wound, ulcer, or bone fracture within the past 28 days
• Significant traumatic injury within the past 28 days
• Neuropathy ≥ grade 2
• Ongoing or active infection
• Concurrent prophylactic filgrastim (G-CSF) or sargramostim (GM-CSF)
• Prior chemotherapy for metastatic disease. Adjuvant therapy completed at least 12 months before first evidence of metastasis allowed
• Cardiovascular, renal, hepatic, or other nonmalignant systemic disease that would preclude study therapy