Combination Chemotherapy Plus Bevacizumab With or Without Oxaliplatin in Treating Older Patients With Metastatic Colorectal Cancer

Men of child bearing potential who are unwilling to employ adequate contraception

Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of the safety and adverse events of the prescribed regimens

Immunocompromised patients (other than that related to the use of corticoid steroids) including patients known to be human immunodeficiency virus (HIV) positive with cluster of differentiation (CD)4 \< 100 cells/uL

Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements

Receiving any other investigational agent which would be considered as a treatment for the primary neoplasm

Other active malignancy =\< 3 years prior to randomization; EXCEPTIONS: non-melanotic skin cancer or carcinoma-in-situ of the cervix; NOTE: if there is a history of prior malignancy, patients must not be receiving other specific treatment (other than hormonal therapy) for this prior cancer

Prior chemotherapy, radiation therapy, immunotherapy, or biological therapy for recurrent or metastatic colorectal cancer

\* NOTE: prior chemotherapy or radiotherapy is permitted if they had been administered as adjuvant or neoadjuvant therapy and a complete surgical resection of the original colorectal cancer had been achieved

Progressive disease =\< 12 months of completing oxaliplatin-containing adjuvant therapy

Prior radiation to \> 30% of the bone marrow at any time

Calculated creatinine clearance \< 60 mL/minute

\* NOTE: If calculated creatinine clearance does not meet eligibility requirement, a 24-hour urine can be collected for a creatinine clearance, and the patient can been rolled if measured creatinine clearance \>= 60 mL/minute

Known central nervous system or brain metastasis that are either symptomatic or untreated; Note: if a patient has a resection of the metastasis and is no longer symptomatic, the patient is eligible for the study; Note: patients with neurological symptoms must undergo a computed tomography (CT) scan/magnetic resonance imaging (MRI) of the brain to exclude brain metastasis

New York Heart Association (NYHA) classification III or IV congestive heart failure

Inadequately controlled hypertension (systolic blood pressure of \> 150 mm Hg or diastolic blood pressure \> 100 mm Hg on anti-hypertensive medications)

Major surgical procedures, open biopsy or significant traumatic injury =\< 28 days prior to randomization or anticipation of need for elective or planned major surgical procedure during the course of the study

Core biopsy or other minor surgical procedures =\< 7 days prior to randomization

\* NOTE: Placement of a vascular access device is allowed

Active or recent hemoptysis (\>= ½ teaspoon of bright red blood per episode) =\< 30 days prior to randomization

History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess =\< 6 months prior to randomization

Serious non-healing wound, active ulcer, or untreated bone fracture

\* NOTE: patients with fractures secondary to metastatic disease are eligible after appropriate radiotherapy

History of hypertensive crisis or hypertensive encephalopathy

Patient has experienced any arterial thromboembolic events including, but not limited to myocardial infarction, stroke, transient ischemic attack (TIA), cerebrovascular accident, unstable angina =\< 6 months prior to randomization or congestive heart failure requiring use of ongoing maintenance therapy for life-threatening ventricular arrhythmias

Significant vascular disease (e.g., aortic aneurysm, aortic dissection) or recent peripheral arterial thrombosis =\< 6 months prior to randomization

Evidence or history of bleeding diathesis (greater than normal risk of bleeding) or coagulopathy (in the absence of therapeutic anticoagulation) any hemorrhage/bleeding event \> grade 3 =\< 4 weeks prior to randomization; patients with full-dose anticoagulants are eligible provided the patient has been on a stable dose, at least 2 weeks, of low molecular weight heparin or warfarin and has an INR range 2-3; aspirin doses \> 325 mg daily are not allowed

Known hypersensitivity to any of the components of 5-fluorouracil/leucovorin, capecitabine, oxaliplatin, or bevacizumab

Clinically significant peripheral neuropathy at the time of randomization (defined in the National Cancer Institute \[NCI\] Common Terminology Criteria for Adverse Events \[CTCAE\] version \[v\]4.0 as \>= grade 2 neurosensory or neuromotor toxicity)

What this study is about