FOLFOX +/- Ziv-Aflibercept for Esophageal and Gastric Cancer

Exclusion Criteria

• •History of hypertension unless adequately controlled
• •Evidence of active bleeding from primary tumor at time of study entry
• •Pregnant or breastfeeding
• •Squamous cell carcinoma histology
• •Prior treatment for advanced or metastatic disease
• •Palliative radiation to \< 25% of bone marrow must have been completed 2 weeks prior to study entry, palliative RT to \> 25% must have been completed 4 weeks prior to study entry
• •Known allergy to study agents
• •Known dihydropyrimidine dehydrogenase deficiency or thymidylate kinase gene polymorphism predisposing participant to 5-FU toxicity
• •History of symptomatic congestive heart failure
• •Clinically significant peripheral arterial disease
• •Grade 2 or higher sensory or motor neuropathy
• •Serious unhealed wound, ulcers or bone fractures
• •History of HIV positivity or hepatitis B or C
• •History of abdominal fistula, wound dehiscence, GI perforation, intra abdominal abscess, uncontrolled GI bleeding or diverticulitis that required hospitalization within 6 months of study entry
• •History of arterial thrombotic events
• •History of CNS hemorrhage in past 6 months
• •Use of warfarin
• •History of prior or synchronous malignancy except if treated with curative intent more than 3 years prior to enrollment, or adequately treated non-melanoma skin cancers, cervical carcinoma in situ or prostatic intraepithelial neoplasia without evidence of prostate cancer
• •Uncontrolled non-malignant illness
• •Uncontrolled psychiatric illness