Bevacizumab, Docetaxel, and Gemcitabine Patients With Stage IIIB, Stage IV, or Recurrent Non-Small Cell Lung Cancer

DISEASE CHARACTERISTICS:

Histologically confirmed non-squamous cell non-small cell lung cancer

Stage IIIB (with pleural effusion), stage IV, or recurrent disease
Bidimensionally measurable disease

No known CNS disease, except for previously treated brain metastasis defined as no evidence of progression or hemorrhage after treatment AND no ongoing requirement for dexamethasone as documented by clinical examination, MRI, or CT scan

Treatment for brain metastases may have included whole brain radiotherapy, radiosurgery (gamma knife, LINAC, or equivalent), or a combination of therapy as deemed appropriate by the treating physician
Stable dose of anticonvulsants allowed
No known metastatic disease to the gastrointestinal tract (e.g., stomach, small bowel, or large bowel)

PATIENT CHARACTERISTICS:

ECOG performance status 0-1
Life expectancy > 3 months
ANC ≥ 1,500/mm^3
Platelet count ≥ 100,000/mm^3
Hemoglobin ≥ 9 g/dL
Bilirubin ≤ 2.0 mg/dL
AST or ALT ≤ 2.5 times upper limit of normal (ULN) (≤ 5.0 times ULN if hepatic metastases are present)
Serum creatinine ≤ 1.8 mg/dL
Urine protein:creatinine ratio < 1.0 OR proteinuria < 2+ by urine dipstick OR ≤ 1 g of protein by 24-hour urine collection
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
Available for regular follow-ups
No inadequately controlled hypertension, defined as systolic BP > 150 mm Hg and/or diastolic BP > 100 mm Hg despite antihypertensive medications
No history of hypertensive crisis or hypertensive encephalopathy
No NYHA class II-IV congestive heart failure
No myocardial infarction or unstable angina within the past 6 months
No stroke or transient ischemic attack within the past 6 months
No significant vascular disease (e.g., aortic aneurysm, aortic dissection requiring surgical repair, or recent peripheral arterial thrombosis) within the past 6 months
No symptomatic peripheral vascular disease
No evidence of bleeding diathesis or coagulopathy (in the absence of therapeutic anticoagulation)
No history of colonic diverticular disease (i.e., diverticulosis or diverticulitis)
No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months
No serious, nonhealing wound, ulcer, or bone fracture
No known hypersensitivity to any component of bevacizumab
No hemoptysis (bright red blood of ≥ ½ teaspoon per episode) within the past 3 months
No significant traumatic injury within the past 28 days

PRIOR CONCURRENT THERAPY:

See Disease Characteristics
No prior chemotherapy or biological therapy
No prior radiotherapy to an area of measurable disease unless there is documented progressive disease after completion of therapy
More than 2 weeks since prior radiotherapy
More than 4 weeks since prior and no concurrent participation in another experimental drug study, except for a Genentech-sponsored bevacizumab cancer study
More than 28 days since prior major surgical procedure or open biopsy
More than 3 months since prior abdominal surgery
More than 3 months since prior neurosurgical resection or brain biopsy
More than 7 days since prior core biopsy or other minor surgical procedure, except placement of a vascular access device
No concurrent major surgical procedure