Bevacizumab and Erlotinib in Treating Patients With Metastatic Pancreatic Cancer That Did Not Respond to Previous Treatment With Gemcitabine

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed adenocarcinoma of the pancreas

• Documented extrapancreatic metastases

  • Radiographically measurable disease not required

• Gemcitabine hydrochloride-refractory disease

  • Has undergone 1-3 prior therapies for locally advanced or metastatic disease with ≥ 1 regimen containing gemcitabine hydrochloride (alone or in combination with other agents)

    • Treatment given in the adjuvant setting (radiotherapy and/or chemotherapy, given either concurrently or systemically) does not count as prior therapy as long as progressive disease occurs > 6 months after completion of treatment
• No central nervous system (CNS) or brain metastases

PATIENT CHARACTERISTICS:

• Eastern Cooperative Oncology Group (ECOG) performance status 0-1
• Absolute neutrophil count ≥ 1,500/mm³
• Platelet count ≥ 100,000/mm³
• International Normalized Ratio (INR) ≤ 1.5 (except in patients receiving full-dose warfarin)
• Bilirubin ≤ 2.0 mg/dL
• Creatinine ≤ 2.0 mg/dL
• AST or ALT ≤ 2.5 times upper limit of normal (ULN) (5 times ULN if documented liver metastases)
• Hemoglobin ≥ 9 g/dL (transfusion or epoetin alfa allowed)
• No contact lense use during and for 14 days after completion of study treatment
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for ≥ 6 months after completion of study treatment
• No history of other disease, metabolic dysfunction, or physical examination or clinical laboratory finding that contraindicates use of an investigational drug or precludes study compliance

• No history of serious systemic disease, including any of the following:

  • Myocardial infarction within the past 6 months
  • Stroke within the past 6 months
  • Uncontrolled hypertension (i.e., blood pressure > 150/100 mm Hg on medication)
  • Unstable angina
  • New York Heart Association class II-IV congestive heart failure

  • Unstable symptomatic arrhythmia requiring medication

    • Chronic atrial arrhythmia (i.e., atrial fibrillation or paroxysmal supraventricular tachycardia) allowed
  • Peripheral vascular disease ≥ grade 2
• No significant traumatic injury within the past 28 days
• No proteinuria (defined as urine protein:creatinine ratio ≥ 1.0 at screening)
• No clinically significant impairment of renal function
• No serious, nonhealing wound, ulcer, or bone fracture
• No evidence of bleeding diathesis or coagulopathy
• No history of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months

PRIOR CONCURRENT THERAPY:

• More than 28 days since prior major surgery or open biopsy
• More than 7 days since prior fine-needle aspiration or core biopsy

• No prior antiangiogenesis agent (e.g., bevacizumab or an oral vascular endothelial growth factor receptor small molecule inhibitor) given together with an agent that disrupts epidermal growth factor receptor signaling (e.g., cetuximab or erlotinib hydrochloride) for locally advanced or metastatic pancreatic cancer

  • Prior treatment with either one of the above alone allowed
• More than 4 weeks since prior and no concurrent participation in another clinical trial
• No other concurrent antineoplastic or antitumor agents, including chemotherapy, radiotherapy, immunotherapy, or hormonal anticancer therapy
• No concurrent major surgery
• No other concurrent investigational agents