Combination Chemotherapy and Monoclonal Antibody Therapy in Treating Patients With Advanced Colorectal Cancer With Liver Metastases or Lung Metastases That Are Potentially Removable by Surgery

DISEASE CHARACTERISTICS:

Inclusion criteria:

• Histologically confirmed metastatic colorectal adenocarcinoma

• Bidimensionally measurable metastatic disease limited to the liver and considered curatively resectable after response to systemic therapy as assessed by a surgical board

  • Additional metastatic disease to the lungs consisting of no more than 3 potentially resectable lesions allowed
  • Must have at least one lesion of 30 mm or less

Exclusion criteria:

• History or evidence upon physical examination of CNS disease unless adequately treated (e.g., uncontrolled seizure with standard medical therapy or history of stroke)

PATIENT CHARACTERISTICS:

Inclusion criteria:

• Performance status ≤ 1
• Life expectancy > 12 weeks
• WBC ≥ 3,000/mm^3
• Platelet count ≥ 100,000/mm^3
• Creatinine 1.25 x upper limit of normal (ULN)
• Bilirubin 1.25 x ULN (1.5 x ULN if liver metastasis)
• AST and ALT ≤ 3 x ULN (≤ 5 x ULN if liver metastasis)
• Woman and men of childbearing age must use adequate contraception

Exclusion criteria:

• Pregnancy (positive serum pregnancy test) or lactation
• Chronic diarrhea ≥ grade 2

• Other serious illness or medical condition including any of the following:

  • Unstable cardiac disease requiring treatment
  • Congestive heart failure or angina pectoris even if medically controlled
  • Significant arrhythmias
  • History of significant neurologic or psychiatric disorders including psychotic disorders, dementia, or seizures that would prohibit the understanding and giving of informed consent
  • Active uncontrolled infection
  • Severe hypercalcemia
  • Other serious underlying medical condition that could impair the ability of the patient to participate in the study
  • Neuropathy > grade 1 of any etiology
• Known DPD deficiency
• Known severe polyneuropathy
• Known allergy to Chinese hamster ovary cell proteins, other recombinant human or humanized antibodies, any excipients of bevacizumab formulation, or any other study drugs
• Chronic inflammatory bowel disease
• Acute or subacute intestinal occlusion
• History of previous arterial thromboembolism
• Uncontrolled hypertension
• Evidence of bleeding diathesis or coagulopathy
• Serious nonhealing wound, ulcer, or bone fracture
• History of tumor other than basocellular carcinoma of the skin
• Peripheral neuropathy > grade 1 of any origin (e.g., alcohol)
• Significant traumatic injury within 28 days prior to study treatment

PRIOR CONCURRENT THERAPY:

Exclusion criteria:

• No prior chemotherapy for metastatic disease

  • Prior adjuvant chemotherapy permitted if interval since last treatment administration and recurrence is > 6 months
• Major surgical procedure or open biopsy within 28 days prior to study treatment or anticipation of the need for major surgical procedure during the course of the study
• Treatment in a clinical trial within 30 days prior to study entry
• Concurrent treatment with other experimental drugs or other anticancer therapy
• Current or recent use (within 10 days prior to study treatment) of full-dose oral or parenteral anticoagulants for therapeutic purposes
• Chronic daily treatment with aspirin (> 325 mg/day)