Carboplatin, Docetaxel, Bevacizumab, and Erlotinib Versus Chemotherapy Alone in Resected NSCLC

Exclusion Criteria

• •4. No evidence of metastatic disease
• •5. ANC \>= 1500, platelets \>= 100,000 and hemoglobin \>= 10.0.
• •6. Total bilirubin \<= ULN. AST and ALT and alkaline phosphatase must be WNL
• •7. Serum creatinine \<= 1.5mg/dl (If greater than 1.5, the creatinine clearance, calculated according to the Cockroft-Gault formula, must be \>= 50ml/min).
• •8. Patients may have had no previous chemotherapy, radiation therapy, angiogenesis inhibitor, or tyrosine kinase inhibitor for non-small cell lung cancer.
• •9. Patients must be able to understand the nature of this study and give written informed consent.
• •10. Age \>= 18 years
• •11. Ability to start treatment between 8 and 12 weeks following surgery.
• •12. Ability to take oral medication.
• •1. Patients with preoperative radiologic evidence of N2 disease by either PET or CT scan (i.e. radiological evidence of metastasis to ipsilateral mediastinal and subcarinal nodes) that is confirmed as N2 disease histologically are excluded. - PLEASE SEE EXCEPTION in section 3.1.2 of protocol
• •2. Mixed small cell and non-small cell histologies
• •3. Pulmonary carcinoid tumors
• •4. Positive bronchial margins
• •5. History of prior malignancy within 5 years with the exception of skin cancer or cervical carcinoma in situ.
• •6. Women who are pregnant (positive pregnancy test) or breast-feeding. Subjects of childbearing potential or with partners of childbearing potential (women and men) must use effective birth control measures during treatment.
• •7. Treatment with a non-approved or investigational drug within 30 days before day 1 of trial treatment.
• •8. Patients with seizures not controlled with standard medical therapy.
• •9. Patients with active infection requiring parenteral antibiotics
• •10. Patients who have had major surgical procedure, open biopsy, or significant traumatic injury within 8 weeks of beginning study treatment or anticipation of need for major surgical procedure during the course of the study
• •11. Fine needle aspiration, core biopsy or other minor surgical procedure (excluding placement of a vascular access device) within 7 days of beginning study treatment.
• •12. Patients receiving thrombolytic therapy within 10 days of starting study treatment are also ineligible. Patients may receive prophylactic anticoagulation therapy, 1 mg coumadin daily for port clot prophylaxis.
• •13. Patients with proteinuria at screening as demonstrated by either:
• •* Urine protein creatinine (UPC) ratio \>= 1.0 at screening OR
• •* Urine dipstick for proteinuria \>= 2+ (patients discovered to have \>= 2+ proteinuria on dipstick urinalysis at baseline should undergo a 24 hour urine collection and must demonstrate \>= 1 g of protein in 24hours to be eligible).
• •14. Patients with serious nonhealing wound, ulcer, or bone fracture.
• •15. Patients with evidence of bleeding diathesis or coagulopathy.
• •16. Patients with history of hemoptysis defined as bright red blood of ½ teaspoon or more per episode) within 8 weeks prior to study treatment.
• •17. History of myocardial infarction or unstable angina within 6 months of beginning study treatment.
• •18. Inadequately controlled hypertension (defined as systolic blood pressure \> 150 and /or diastolic blood pressure \> 100 mmHg on antihypertensive medications).
• •19. New York Heart Association (NYHA) grade II or greater CHF.
• •20. Serious cardiac arrhythmia requiring medication.
• •21. Symptomatic peripheral vascular disease.
• •22. History of stroke or transient ischemic attack within 6 months prior to beginning bevacizumab.
• •23. Any prior history of hypertensive crisis or hypertensive encephalopathy.
• •24. History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to beginning study treatment.
• •25. ECOG Performance status \> 1.
• •26. Peripheral neuropathy\> grade 1.
• •27. Known hypersensitivity to any component of study drugs including platinum or to drugs formulated with polysorbate 80.
• •28. Impaired oral absorption.
• •29. Inability to comply with study and/or follow-up procedures.