Radiation Therapy, Chemotherapy, and Bevacizumab in Treating Patients With Recurrent, Unresectable or Stage III or Stage IV Non-Small Cell Lung Cancer

DISEASE CHARACTERISTICS:

Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)

Predominantly squamous cell histology
Cytologic or histologic elements can be established on metastatic tumor aspirates or biopsy

Advanced disease, meeting 1 of the following staging criteria:

Stage IIIB disease with malignant pleural effusion
Stage IV disease
Recurrent, unresectable disease
Measurable or nonmeasurable disease
No extrathoracic only disease
No known CNS metastases by head CT scan with contrast or MRI

PATIENT CHARACTERISTICS:

ECOG performance status 0-1
Platelet count > 100,000/mm^3
Absolute neutrophil count > 1,500/mm^3
Bilirubin < 1.5 mg/dL
Transaminases < 5 times upper limit of normal (ULN)
Creatinine clearance ≥ 45 mL/min
Urine protein:creatinine ratio ≤ 1.0 by spot urinalysis
INR < 1.5 ULN
PTT normal
Not pregnant or nursing
Negative pregnancy test
Fertile patients use effective contraception
No serious nonhealing wound, ulcer, or bone fracture
No ongoing or active infection
No ongoing fever
No myocardial infarction within the past 6 months
No stroke within the past 6 months
No history of hypertension unless well-controlled (i.e., blood pressure < 150/100 mmHg on a stable regimen of antihypertensive therapy)
No New York Heart Association grade III or IV congestive heart failure
No serious cardiac arrhythmia requiring medication
No unstable angina pectoris
No peripheral vascular disease ≥ grade 2
No other clinically significant cardiovascular disease
No abdominal fistula
No gastrointestinal perforation
No intra-abdominal abscess within the past 6 months
No psychiatric illness or social situation that would preclude study compliance
No other malignancy curatively treated within the past 5 years
No history of thrombotic or hemorrhagic disorders
No gross hemoptysis (i.e., red blood ≥ ½ teaspoon) within the past 3 months
No bleeding requiring intervention or ≥ grade 2

PRIOR CONCURRENT THERAPY:

Recovered from prior therapy
No prior systemic chemotherapy for metastatic NSCLC
More than 6 months since prior adjuvant chemotherapy for early stage (i.e., stage IB-IIIA) NSCLC
More than 3 weeks since prior immunotherapy, hormonal therapy, or radiotherapy
More than 28 days since prior and no concurrent major surgery
More than 7 days since prior minor surgery, fine-needle aspiration, or core biopsy
More than 4 weeks since prior and no concurrent participation in another experimental drug study

No concurrent therapeutic anticoagulation

Concurrent prophylactic anticoagulation of venous access device allowed
No concurrent chronic treatment with aspirin (> 325 mg/day) or nonsteroidal anti-inflammatory drugs known to inhibit platelet function
No concurrent dipyridamole, ticlopidine, clopidogrel, or cilostazol