Bevacizumab in Treating Patients With Unresectable Nonmetastatic Liver Cancer

Inclusion Criteria:

* Histologically confirmed hepatocellular carcinoma

  * Confirmed by needle aspirate, biopsy, or prior surgical resection specimen
* Clinically confirmed hepatocellular carcinoma defined as follows:

  * Cirrhosis or chronic hepatitis B or C virus infection, with 1 or more hypervascular liver masses more than 2 cm
  * Alpha-fetoprotein (AFP) greater than 400 ng/mL OR greater than 3 times normal and doubling in value during the past 3 months
* Deemed unresectable

  * Prior surgical resection allowed
  * Recurrence after hepatic resection or other procedure allowed
  * Tumor that extends into branches of the portal or hepatic veins allowed
  * No tumor invading the main portal vein (portal trunk) or inferior vena cava
  * No tumor occupying more than 50% of the liver volume
* Enlargement/involvement of regional lymph nodes allowed
* At least 1 unidimensionally measurable lesion at least 20 mm

  * No poorly defined lesions
  * No vague hypervascular patches
* Child-Pugh class A or compensated Child-Pugh class B liver dysfunction

  * No Child-Pugh class C or uncompensated class B indicated by active encephalopathy, persistent ascites, or prothrombin time greater than 1.5 times normal
  * Prior ascites allowed if manageable with diuretics alone
  * No repeated paracentesis (more than 1 per month)
* No extrahepatic metastasis
* No documented brain metastases
* No history or clinical evidence of CNS disease (e.g., primary brain tumor, seizures uncontrolled with standard medical therapy, or history of stroke)
* Performance status - ECOG 0-2
* Absolute neutrophil count greater than 1,500/mm\^3
* Hemoglobin at least 8 g/dL
* Platelet count at least 75,000/mm\^3
* No prior serious bleeding event (unrelated to liver disease)
* No bleeding diathesis
* No coagulopathy
* Bilirubin no greater than 3 mg/dL
* Transaminases less than 5 times upper limit of normal (ULN)
* Albumin at least 2.5 mg/dL
* PTT less than 4 seconds above ULN
* INR less than 1.5 (for patients receiving warfarin)
* Creatinine less than 1.5 g/dL
* Urine protein less than 500 mg/24hrs\*

Exclusion criteria:

* No thromboembolic event within the past 12 months
* No clinically significant cardiovascular disease
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No active infection requiring parenteral antibiotics
* No serious non-healing wound/ulcer or bone fracture
* No variceal bleeding within the past 6 months
* No malignancy within the past 5 years except localized nonmelanoma skin cancer
* No ongoing psychiatric or social situation that would preclude study compliance
* No known hypersensitivity to Chinese hamster ovary cell products
* No known hypersensitivity to other recombinant human antibodies
* No more than 1 prior biologic therapy
* No concurrent interferon
* No concurrent interleukin-2
* No more than 1 prior antineoplastic chemotherapy
* At least 4 weeks since prior invasive surgery, including open biopsy
* At least 2 weeks since prior needle biopsy (core or fine-needle aspirate)
* No concurrent hepatic transplant
* At least 4 weeks since prior anticancer therapy
* No concurrent platelet-stimulating factors (e.g., oprelvekin)
* No concurrent full-dose anticoagulants or thrombolytic agents (except as required to maintain patency of pre-existing, permanent indwelling IV catheters)
* No chronic daily antiplatelet drugs (e.g., aspirin doses of 325 mg/day or higher or non-steroidal anti-inflammatory drugs)