Cisplatin, Bevacizumab, and Gemcitabine Followed by Surgery, Bevacizumab, and Paclitaxel in Treating Patients With Locally Advanced Nonmetastatic Bladder Cancer That Can Be Removed By Surgery

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically confirmed transitional cell cancer (TCC) of the bladder
• •* Staged as follows:
• •* Muscle invasive (T2-T4a)
• •* Node negative (N0)
• •* No histologically or cytologically proven lymph node metastases
• •* Nonmetastatic (M0)
• •* No evidence of distant metastases
• •Resectable disease
• •Able to begin protocol treatment within 6 weeks after transurethral resection and cystoscopic evaluation
• •No central nervous system or brain metastases
• •PATIENT CHARACTERISTICS:
• •ECOG performance status of 0-2
• •Karnofsky 60-100%
• •White blood cell count ≥ 3,000/mm\^3
• •Absolute neutrophil count ≥ 1,500/mm\^3
• •Platelet count ≥ 100,000/mm\^3
• •AST(SGOT) and ALT(SGPT) ≤ 2 times upper limit of normal
• •Bilirubin ≤1.5 mg/dL
• •Creatinine clearance ≥ 60 mL/min
• •Urine protein/creatinine ratio \< 1.0
• •Blood pressure ≤150/100 mm Hg
• •No prohibitive medical risks for chemotherapy
• •No history of allergic reactions attributed to compounds of similar chemical or biologic composition to cisplatin, gemcitabine hydrochloride, or paclitaxel
• •No unstable angina
• •No history of myocardial infarction within the past 6 months
• •No cardiac arrhythmias
• •No New York Heart Association (NYHA) congestive heart failure ≥ grade 2
• •No history of stroke within the past 6 months
• •No clinically significant peripheral vascular disease
• •No evidence of bleeding diathesis or coagulopathy
• •No history of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months
• •No serious nonhealing wound, ulcer, or bone fracture
• •No psychiatric illness or other psychosocial situation that would limit ability to comply with study and/or follow-up procedures
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must agree to use adequate contraception prior to study entry and for the duration of study participation
• •No significant traumatic injury with in the past 28 days
• •PRIOR CONCURRENT THERAPY:
• •No prior systemic chemotherapy
• •No prior pelvic radiation therapy
• •More than 4 weeks since prior participation in an experimental drug study other than a Genentech-sponsored bevacizumab cancer study
• •No concurrent participation in an experimental drug study other than a Genentech-sponsored bevacizumab cancer study
• •No major surgical procedure or open biopsy within the past 28 days
• •No anticipation of need for major surgical procedure during the course of the study
• •No minor surgical procedures, fine-needle aspirations, or core biopsies within the past 7 days
• •No concurrent treatment with hormones or other chemotherapeutic agents except the following:
• •* Steroids given for adrenal failure
• •* Hormones administered for nondisease-related conditions (e.g., insulin for diabetes)
• •* Intermittent use of dexamethasone as an antiemetic in solid tumor protocols
• •No other concurrent investigational or commercial agents or therapies