Capecitabine, Cetuximab, Oxaliplatin, and Bevacizumab in Treating Patients With Metastatic or Recurrent Colorectal Cancer That Cannot Be Removed By Surgery

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically confirmed adenocarcinoma of the colon or rectum
• * Unresectable disease
• * Metastatic or recurrent disease
• Not amenable to potentially curative treatment
• No untreated leptomeningeal or brain metastases
• PATIENT CHARACTERISTICS:
• Performance status
• ECOG 0-2
• Life expectancy
• Not specified
• Hematopoietic
• Absolute neutrophil count ≥ 2,000/mm\^3
• Platelet count ≥ 100,000/mm\^3
• No known uncontrolled coagulopathy
• Hepatic
• AST and ALT \< 2.5 times upper limits of normal (ULN) (5 times ULN if liver metastases are present)
• Bilirubin \< 2.0 times ULN
• Renal
• Creatinine clearance \> 40 mL/min
• Urine protein negative
• Urine protein:creatinine ratio \> 1
• Cardiovascular
• No unstable or uncontrolled hypertension (i.e., blood pressure \[BP\] \> 150/100 mm Hg despite antihypertensive therapy)
• * Patients who recently started or have adjusted antihypertensive medications are eligible provided BP is \< 140/90 mm Hg for ≥ 3 different measurements over 14 days
• No arterial thromboembolic events within the past 6 months, including any of the following:
• * Transient ischemic attack
• * Cerebrovascular accident
• * Unstable angina
• * Myocardial infarction
• * Clinically significant peripheral vascular disease
• No New York Heart Association class III-IV congestive heart failure
• No uncontrolled symptomatic coronary artery disease or cardiac arrhythmia
• No other significant uncontrolled cardiac disease
• Gastrointestinal
• No lack of physical integrity of the upper gastrointestinal tract
• No malabsorption syndrome
• No inability to tolerate oral medication
• Immunologic
• No prior severe infusion reaction to a monoclonal antibody
• No history of an allergic reaction attributed to compounds of similar chemical or biologic composition to oxaliplatin, cetuximab, capecitabine, or bevacizumab
• No prior unanticipated, severe reaction to fluoropyrimidine therapy or known hypersensitivity to fluoroucacil
• Other
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during the study and for 3-4 months after completion of study treatment
• No peripheral neuropathy ≥ grade 2
• No other malignancy within the past 5 years except adequately treated nonmelanoma skin cancer or carcinoma in situ of the cervix
• No known dihydropyrimidine dehydrogenase deficiency
• PRIOR CONCURRENT THERAPY:
• Biologic therapy
• No prior adjuvant bevacizumab or cetuximab
• No other concurrent anticancer immunotherapy or biologic therapy
• Chemotherapy
• At least 6 months since a prior adjuvant fluorouracil-, leucovorin calcium-, or capecitabine-based regimen
• At least 12 months since prior adjuvant oxaliplatin
• No prior chemotherapy for metastatic or recurrent disease
• Endocrine therapy
• No concurrent hormonal therapy
• Radiotherapy
• No concurrent radiotherapy
• Surgery
• More than 4 weeks since prior major surgery and recovered
• More than 6 months since vascular surgery, stenting, or angioplasty
• Other
• At least 4 weeks since prior and no concurrent sorivudine or brivudine
• More than 4 weeks since prior participation in any investigational drug study
• No prior therapy that affects or targets the epidermal growth factor pathway
• No concurrent cimetidine
• * Concurrent ranitidine, famotidine, or proton-pump inhibitors allowed
• Concurrent anticoagulation therapy with full-dose anticoagulant allowed provided dose is stable for at least 2 weeks