A Phase 2 Study of Sequential and Concurrent Chemoradiation for Patients With Advanced Nasopharyngeal Carcinoma (NPC)

Inclusion Criteria:

- Histologically or cytologically confirmed nasopharyngeal carcinoma meeting the
following criteria:

- WHO type I, II, or III

- Stage II -IVB disease (minimally T2a, N0, M0 or any T any, N1, M0)

- Measurable disease, defined as >= 1 lesion that can be accurately measured in >=
1 dimension as >= 20 mm by conventional techniques or as >= 10 mm by spiral CT
scan

- Prior diagnostic surgery(s) at the primary site or neck allowed provided there
is still measurable disease present

- No known brain metastases

- ECOG performance status 0-1

- Life expectancy > 3 months

- ANC >= 1,500/mm^3

- Platelet count >= 100,000/mm^3

- Total bilirubin <= 1.5 times ULN

- AST and ALT <= 2.5 times ULN

- Creatinine <= 1.5 mg/dL or creatinine clearance >= 55 mL/min- NOTE: * Patients with
creatinine > grade 1 but < grade 3, hearing loss >= grade 2, and peripheral
neuropathy >= grade 2 are eligible provided they receive carboplatin in place of
cisplatin throughout study treatment

- Not pregnant or nursing

- Fertile patients must use effective contraception prior to and during study treatment

- Hearing loss < grade 2. Hearing loss grade 2 or greater attributable to tumor
obstruction, when the bone conduction in the audiogram is consistent with less than
grade 2, is permissible for cisplatin. Hearing loss will be evaluated by hearing in
the best ear. If hearing loss is grade 2, patients are still eligible but should
receive carboplatin throughout the protocol instead of cisplatin.

- Peripheral motor/sensory neuropathy < grade 2. If peripheral neuropathy is grade 2,
patients are still eligible but should receive carboplatin throughout the protocol
instead of cisplatin.

- No uncontrolled intercurrent illness including, but not limited to, any of the
following:

- Ongoing or active infection

- Symptomatic congestive heart failure

- Unstable angina pectoris

- Cardiac arrhythmia

- Psychiatric illness or social situations that preclude compliance with study
requirements

- No clinically significant cardiovascular disease

- No cerebrovascular accident within the past 6 months

- No myocardial infarction or unstable angina within the past 6 months

- No NYHA class II-IV congestive heart failure

- No serious and inadequately controlled cardiac arrhythmia

- No significant vascular disease (e.g., aortic aneurysm, history of aortic
dissection)

- No clinically significant peripheral vascular disease

- No history of allergic reaction attributed to compounds of similar chemical or
biologic composition to docetaxel, cisplatin, carboplatin, fluorouracil,
bevacizumab, or other agents used in this study

- No concurrent combination antiretroviral therapy for HIV-positive patients

- No prior chemotherapy or radiotherapy for nasopharyngeal carcinoma