A Phase 2 Study Of Neoadjuvant rhuMAb VEGF (Bevacizumab) In Combination With Paclitaxel And Carboplatin In Surgically Resectable Non-Small Cell Lung Cancer
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed non-small cell lung cancer
- Stage IB (T2, N0), II (T1 or T2, N1 or T3, N0), or IIIA (T3, N1)
- Potentially resectable disease
- No large central primary tumors in proximity to significant blood vessels
- No bronchoscopically evident endobronchial tumors
- At least 1 unidimensionally measurable lesion
- At least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan
- No known brain metastases
PATIENT CHARACTERISTICS:
Age:
- 18 and over
Performance status:
- ECOG 0-1 OR
- Karnofsky 70-100%
Life expectancy:
- More than 12 months
Hematopoietic:
- WBC at least 3,000/mm^3
- Absolute neutrophil count at least 1,500/mm^3
- Platelet count at least 100,000/mm^3
- No history of an inherited bleeding disorder
- No inherited predisposition to a hypercoagulable state
- No clinically evident hypercoagulable state or bleeding diathesis
Hepatic:
- Bilirubin less than 1.5 times upper limit of normal (ULN)
- AST/ALT no greater than 2.5 times ULN
- INR less than 1.5
- PTT less than 36 seconds
Renal:
- Creatinine less than 1.5 times ULN OR
- Creatinine clearance at least 60 mL/min
- No nephrotic syndrome
- Urine protein no greater than 0.5 g/24 hours
Cardiovascular:
- No poorly controlled hypertension (greater than 150 mm Hg systolic and/or greater
than 100 mm Hg diastolic) despite treatment
- No uncompensated coronary artery disease
- No myocardial infarction within the past 6 months
- No clinically significant or severe peripheral vascular disease
- No inherited predisposition to thrombosis
- No deep venous or arterial thrombosis
- No symptomatic congestive heart failure
- No unstable angina pectoris within the past 6 months
- No cardiac arrhythmia
- No transient ischemic attack within the past 6 months
- No cerebrovascular accident within the past 6 months
- No other arterial thromboembolic event within the past 6 months
Pulmonary:
- No hemoptysis
- No pulmonary embolism
Other:
- No history of allergic reactions to compounds of similar chemical or biologic
composition to study drugs
- No known hypersensitivity to Chinese hamster ovary cell products or other recombinant
human or humanized antibodies
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No psychiatric illness or social situation that would preclude study compliance
- No significant traumatic injury within the past 28 days
- No uncontrolled concurrent illness
- No ongoing or active infection
- No serious, non-healing wound, ulcer, or bone fracture
- No other active malignancy
- No requirement for full-dose anticoagulation or thrombolytic therapy
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- No prior biologic therapy for this cancer
- No concurrent prophylactic growth factors (e.g., epoetin alfa, filgrastim [G-CSF], or
sargramostim [GM-CSF])
Chemotherapy:
- No prior chemotherapy for this cancer
- Prior chemotherapy for another malignancy allowed provided the prior malignancy was
curatively treated and is currently controlled
Endocrine therapy:
- No prior endocrine therapy for this cancer
Radiotherapy:
- No prior radiotherapy for this cancer
- Prior radiotherapy for another malignancy allowed provided the prior malignancy was
curatively treated and is currently controlled
- No concurrent radiotherapy
Surgery:
- Prior diagnostic bronchoscopy, mediastinoscopy, or CT-guided biopsy allowed
- At least 28 days since prior major surgical procedure or open biopsy
Other:
- No other concurrent investigational agents
- No other concurrent anticancer investigational or commercial agents or therapies
- No concurrent combination antiretroviral therapy for HIV-positive patients
- Concurrent low-dose warfarin for maintenence of preexisting, permanent, indwelling IV
catheters allowed provided INR less than 1.5