Carboplatin, Pemetrexed Disodium, and Bevacizumab in Treating Patients With Stage IIIB, Stage IV, or Recurrent Non-Small Cell Lung Cancer

DISEASE CHARACTERISTICS:

Histologically* or cytologically* confirmed non-small cell lung cancer

Any histology, except squamous cell carcinoma, allowed

Mixed tumors will be categorized by the predominant cell type unless small cell elements are present, in which case the patient is ineligible
No histology in close proximity to a major vessel or cavitation NOTE: *Histologic or cytologic elements may be established on metastatic tumor aspirates or biopsy

Meets 1 of the following stage criteria:

Stage IIIB disease (with malignant pleural effusion)
Stage IV disease
Recurrent disease
Measurable or non-measurable disease
No known CNS metastases by CT scan or MRI

PATIENT CHARACTERISTICS:

Age

18 and over

Performance status

ECOG 0-1

Life expectancy

Not specified

Hematopoietic

Absolute neutrophil count > 1,500/mm^3
Platelet count > 100,000/mm^3
No history of hemorrhagic disorders

Hepatic

Bilirubin < 1.5 mg/dL
AST and ALT < 5 times upper limit of normal
INR < 1.5
PTT normal

Renal

Creatinine clearance ≥ 45 mL/min
Urine protein:creatinine ≤ 1.0 by spot urinalysis

Cardiovascular

No myocardial infarction within the past 6 months
No New York Heart Association class II-IV congestive heart failure
No unstable angina pectoris
No serious cardiac arrhythmia requiring medication
No stroke within the past 6 months
No peripheral vascular disease ≥ grade 2

No uncontrolled hypertension (i.e., blood pressure ≥ 150/100 mm Hg)

Patients with a history of hypertension allowed provided blood pressure is well controlled on a stable regimen of anti-hypertensive therapy
No history of thrombotic disorders
No other clinically significant cardiovascular disease

Pulmonary

No history of gross hemoptysis, defined as bright red blood of a ½ teaspoon or more

Other

Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
Must be willing and able to take daily oral folic acid, intermittent vitamin B_12 injections, and corticosteroid premedication
No ongoing or active infection
No serious, non-healing wound, ulcer, or bone fracture
No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months
No psychiatric illness or social situation that would preclude study compliance

PRIOR CONCURRENT THERAPY:

Biologic therapy

More than 3 weeks since prior immunotherapy

Chemotherapy

No prior systemic chemotherapy

Endocrine therapy

More than 3 weeks since prior hormonal therapy

Radiotherapy

See Disease Characteristics
More than 3 weeks since prior radiotherapy

Surgery

More than 4 weeks since prior major surgery
More than 1 week since prior minor surgery, fine needle aspiration, or core biopsy
No concurrent major surgery

Other

Recovered from all prior therapy
More than 4 weeks since prior and no concurrent participation in another experimental drug study
No aspirin or other nonsteroidal anti-inflammatory drug (NSAID) 2 days before and 2 days after each pemetrexed disodium infusion (5 days before and 2 days after each pemetrexed disodium infusion for NSAIDs with a long half-life [e.g., naproxen, rofecoxib, or celecoxib])

No concurrent therapeutic anticoagulation

Concurrent prophylactic anticoagulation for venous access devices allowed provided requirements for INR and PTT are met

No concurrent administration of any of the following:

Chronic daily treatment with aspirin (> 325 mg per day)

NSAIDs known to inhibit platelet function, including any of the following:

Dipyridamole
Ticlopidine
Clopidogrel
Cilostazol