Evaluation of Bevacizumab and Weekly Docetaxel in Elderly (≥ 75 Years) Patients With Advanced Non-Small Cell Lung Cancer (NSCLC)
Inclusion Criteria
DISEASE CHARACTERISTICS:
Inclusion criteria:
- Histologically or cytologically confirmed non-small cell lung cancer
- Stage III or IV disease
- Stage III disease allowed, provided the patient is not a candidate for
concurrent chemotherapy and radiotherapy
- Mixed histology allowed, provided the biopsy has less than 50% squamous cell
histology
- Measurable or evaluable disease
Exclusion criteria:
- Squamous cell histology
- Evidence of cavitation in the tumor
- Tumors in close proximity to major blood vessels
- No active, untreated brain metastases
- More than 7 days since prior treatment for brain metastases AND no evidence of
hemorrhage in the lesion
- Stable or declining dose of steroids allowed
PATIENT CHARACTERISTICS:
Inclusion criteria:
- ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%
- Life expectancy > 12 weeks
- Leukocytes ≥ 3,000/μL
- Absolute neutrophil count ≥ 1,500/μL
- Platelet count ≥ 100,000/μL
- Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
- AST and ALT ≤ 2.5 times ULN (< 5 times ULN if patients has liver metastases)
- Creatinine ≤ 1.5 times normal
- Left ventricular function ≥ normal by MUGA scan or ECHO
- Urine protein:creatinine ratio ≤ 1.0 AND/OR urine protein ≤ 1+ by dipstick analysis
OR protein ≤ 1 g/24-hour urine collection
- Fertile patients must use effective contraception and women should avoid
breastfeeding
Exclusion criteria:
- Resting blood pressure (BP) consistently > 140/90 mm Hg
- Patients whose BP is controlled (≤ 140 mm Hg systolic and ≤ 90 mm Hg diastolic)
after adjusting, starting, or increasing the medications are eligible
- Significant hemorrhage (i.e., > 30 mL bleeding/episode ) or hemoptysis (i.e., > 5 mL
fresh blood in one episode) in the previous 3 months
- Evidence of bleeding diathesis or coagulopathy
- Significant traumatic injury within the past 28 days
- Abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within
the past 6 months
- History of other active malignancies
- If patient has other cancers such as PSA only (without clinical or radiographic
evidence) prostate cancer, the patient can still be considered for this protocol
if, in the clinical judgment of the treating physician, NSCLC is the most
important malignancy and the other malignancy will not impact patient's overall
survival
- Myocardial infarction or cerebrovascular episode within the past year
- Serious nonhealing wound or ulcer
- Significant vascular disease such as aortic aneurysm, aortic dissection, or
symptomatic peripheral vascular disease
- Uncontrolled concurrent illness that would limit compliance with study requirements
including, but not limited to, the following:
- Ongoing or active infection
- New York Heart Association class II-IV congestive heart failure
- Unstable angina pectoris
- Cardiac arrhythmia
- Psychiatric illness/social situations
- Known hypersensitivity to any component of bevacizumab
PRIOR CONCURRENT THERAPY:
- More than 7 days since prior radiotherapy and recovered
- No concurrent full-dose warfarin or its equivalent (i.e., unfractionated and/or low
molecular-weight heparin)
- More than 10 days since prior and no concurrent aspirin ≥ 325 mg/day or chronic use
of nonsteroidal anti-inflammatory drugs
- More than 28 days since prior and no concurrent major surgical procedure or open
biopsy
- More than 7 days since prior core biopsy or other minor procedure, excluding
placement of a vascular access device
- No other concurrent investigational agents, commercial agents, or therapies
- More than 30 days since prior participation in a trial involving an investigational
agent
- No prior chemotherapy