Carboplatin, Pemetrexed Disodium, and Bevacizumab in Treating Patients With Stage IIIB, Stage IV, or Recurrent Non-Small Cell Lung Cancer

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically\* or cytologically\* confirmed non-small cell lung cancer
• •* Any histology, except squamous cell carcinoma, allowed
• •* Mixed tumors will be categorized by the predominant cell type unless small cell elements are present, in which case the patient is ineligible
• •* No histology in close proximity to a major vessel or cavitation NOTE: \*Histologic or cytologic elements may be established on metastatic tumor aspirates or biopsy
• •Meets 1 of the following stage criteria:
• •* Stage IIIB disease (with malignant pleural effusion)
• •* Stage IV disease
• •* Recurrent disease
• •Measurable or non-measurable disease
• •No known CNS metastases by CT scan or MRI
• •PATIENT CHARACTERISTICS:
• •Age
• •18 and over
• •Performance status
• •ECOG 0-1
• •Life expectancy
• •Not specified
• •Hematopoietic
• •Absolute neutrophil count \> 1,500/mm\^3
• •Platelet count \> 100,000/mm\^3
• •No history of hemorrhagic disorders
• •Hepatic
• •Bilirubin \< 1.5 mg/dL
• •AST and ALT \< 5 times upper limit of normal
• •INR \< 1.5
• •PTT normal
• •Renal
• •Creatinine clearance ≥ 45 mL/min
• •Urine protein:creatinine ≤ 1.0 by spot urinalysis
• •Cardiovascular
• •No myocardial infarction within the past 6 months
• •No New York Heart Association class II-IV congestive heart failure
• •No unstable angina pectoris
• •No serious cardiac arrhythmia requiring medication
• •No stroke within the past 6 months
• •No peripheral vascular disease ≥ grade 2
• •No uncontrolled hypertension (i.e., blood pressure ≥ 150/100 mm Hg)
• •* Patients with a history of hypertension allowed provided blood pressure is well controlled on a stable regimen of anti-hypertensive therapy
• •No history of thrombotic disorders
• •No other clinically significant cardiovascular disease
• •Pulmonary
• •No history of gross hemoptysis, defined as bright red blood of a ½ teaspoon or more
• •Other
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception
• •Must be willing and able to take daily oral folic acid, intermittent vitamin B\_12 injections, and corticosteroid premedication
• •No ongoing or active infection
• •No serious, non-healing wound, ulcer, or bone fracture
• •No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months
• •No psychiatric illness or social situation that would preclude study compliance
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy
• •More than 3 weeks since prior immunotherapy
• •Chemotherapy
• •No prior systemic chemotherapy
• •Endocrine therapy
• •More than 3 weeks since prior hormonal therapy
• •Radiotherapy
• •See Disease Characteristics
• •More than 3 weeks since prior radiotherapy
• •Surgery
• •More than 4 weeks since prior major surgery
• •More than 1 week since prior minor surgery, fine needle aspiration, or core biopsy
• •No concurrent major surgery
• •Other
• •Recovered from all prior therapy
• •More than 4 weeks since prior and no concurrent participation in another experimental drug study
• •No aspirin or other nonsteroidal anti-inflammatory drug (NSAID) 2 days before and 2 days after each pemetrexed disodium infusion (5 days before and 2 days after each pemetrexed disodium infusion for NSAIDs with a long half-life \[e.g., naproxen, rofecoxib, or celecoxib\])
• •No concurrent therapeutic anticoagulation
• •* Concurrent prophylactic anticoagulation for venous access devices allowed provided requirements for INR and PTT are met
• •No concurrent administration of any of the following:
• •* Chronic daily treatment with aspirin (\> 325 mg per day)
• •* NSAIDs known to inhibit platelet function, including any of the following:
• •* Dipyridamole
• •* Ticlopidine
• •* Clopidogrel
• •* Cilostazol