Bevacizumab and Erlotinib Followed by Cisplatin or Carboplatin and Gemcitabine in Treating Patients With Newly Diagnosed or Recurrent Stage IIIB or Stage IV NSCLC

DISEASE CHARACTERISTICS:

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

  * Newly diagnosed or recurrent disease
* Meets 1 of the following staging criteria:

  * Stage IIIB disease, meeting both of the following criteria:

    * Proven malignant effusion or supraclavicular node involvement (i.e., N3 supraclavicular nodes)
    * Not a candidate for curative multimodality treatment or surgery
  * Stage IV disease
* Measurable disease, defined as ≥ 1 lesion (outside of irradiated areas) that can be measured in ≥ 1 dimension as ≥ 10 mm by spiral or multi-slice CT scan or MRI
* Immediate chemotherapy not clinically mandatory in the judgement of the investigator
* No intrathoracic large, centrally located tumors and/or cavitary lesions invading or abutting major blood vessels
* No evidence of clinically active interstitial lung disease

  * Patients with chronic stable radiographic changes who are asymptomatic are eligible
* No small cell lung cancer (SCLC), squamous NSCLC, or combined SCLC-NSCLC tumors
* No brain metastases

PATIENT CHARACTERISTICS:

* WHO performance status 0-1
* Hemoglobin ≥ 10 g/dL
* Absolute neutrophil count ≥ 1,500/mm³
* Thrombocyte count ≥ 100,000/mm³
* Bilirubin ≤ 1.5 times upper limit of normal (ULN)
* ALT ≤ 2.5 times ULN (5 times ULN if liver metastases present)
* Alkaline phosphatase ≤ 2.5 times ULN (5 times ULN if bone metastases present)
* Quick ≥ 70% OR INR ≤ 1.5
* Creatinine ≤ 2.0 times ULN
* Proteinuria ≤ 2+ by urine dipstick
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception during and for 12 months after completion of study treatment
* Able to understand trial information given by the investigator and complete quality of life questionnaire
* No pre-existing condition that would preclude swallowing and/or absorption of oral medication
* No prior or concurrent malignancies, except for the following:

  * Malignancy for which the minimum relapse-free interval is ≥ 5 years
  * Nonmelanoma skin cancer or adequately treated carcinoma in situ of the cervix
* No other medical condition that would preclude study participation, including any of the following:

  * Unstable or uncompensated respiratory, cardiac, hepatic, or renal disease
  * Active infection
  * Uncontrolled diabetes mellitus
  * Hypertension ≥ 150/100 mm Hg despite treatment
  * Myocardial infarction within the past 3 months
  * History of hemorrhagic disorders
  * Non-healing wound, ulcer, or bone fracture
* No clinical history of coagulopathy or thrombosis
* No hemoptysis or hematemesis ≥ grade 2 (defined as bright red blood of ≥ 5 mL per episode) within the past 6 months
* No known hypersensitivity to study drug(s) or to any other component of the study drugs
* No significant traumatic injury within the past 28 days
* No serious underlying medical condition that would impair the ability of the patient to participate in the trial or that would preclude use of study drugs
* No cerebrovascular accident or other CNS bleeding within the past 6 months

PRIOR CONCURRENT THERAPY:

* At least 4 weeks since prior radiotherapy and recovered

  * No prior radiotherapy to lesion(s) selected for measurement
* No prior chemotherapy for advanced disease

  * At least 6 months since prior neoadjuvant or adjuvant systemic chemotherapy for NSCLC
  * Prior intrapleural or intrapericardial local chemotherapy allowed
* No prior endothelial growth factor and/or vascular endothelial growth factor (receptor)-targeted therapy for NSCLC
* More than 28 days since prior major surgical procedure or open biopsy
* More than 30 days since prior treatment in another clinical trial
* No concurrent anticoagulants (e.g., phenprocoumon, acenocoumarol, or full-dose warfarin or heparin)
* No concurrent full-dose continuous use of non-steroid anti-inflammatory drugs (NSAIDs)
* No concurrent aspirin or clopidogrel bisulfate

  * Low-dose aspirin (≤ 325 mg daily) may be continued in patients at high risk for arterial thromboembolic disease
* No other concurrent drugs contraindicated for use with the study drugs, according to the Swissmedic-approved product information
* No other concurrent experimental drugs or anticancer therapy, including chemotherapy, immunotherapy, or hormone therapy