Irinotecan, Cisplatin, Bevacizumab, Radiation Therapy, and Surgery in Treating Patients With Locally Advanced Esophageal Cancer

DISEASE CHARACTERISTICS:

* Histologically confirmed adenocarcinoma of the esophagus or gastroesophageal junction

  * T1, N1, M0 or T2-4, any N, M0 esophageal carcinoma that is surgically resectable
  * Disease must be clinically limited to the esophagus or gastroesophageal junction

    * If tumor extends below the gastroesophageal junction into the proximal stomach, 50% of the tumor must involve the distal esophagus or gastroesophageal junction
* No carcinoma in situ (Tis) or tumors determined to be T1, N0 after endoscopy, endoscopic ultrasound, or CT scan
* No gastric cancers with minor involvement of the gastroesophageal junction or distal esophagus
* No metastatic disease, including any of the following:

  * M1a celiac or supraclavicular disease
  * Positive malignant cytology of the pleura, pericardium, or peritoneum
  * Radiographic evidence of distant organ involvement, including lung, liver, bone, or brain
  * No involvement of nonregional lymph nodes including supraclavicular or celiac lymph node metastases that cannot be contained within a radiation field
* No biopsy-proven tumor invasion of the tracheobronchial tree or presence of tracheoesophageal fistula
* No recurrent laryngeal nerve or phrenic nerve paralysis
* No CNS or brain metastases

PATIENT CHARACTERISTICS:

* ECOG performance status 0-1
* WBC ≥ 3,000/mm³
* Absolute neutrophil count ≥ 1,500/mm³
* Platelet count ≥ 100,000/mm³
* Hemoglobin ≥ 9.0 g/dL
* INR ≤ 1.5 (except for patients requiring full-dose warfarin while on bevacizumab)
* Creatinine ≤ 1.5 mg/dL
* Bilirubin ≤ 1.5 mg/dL
* AST and ALT \< 2.5 times normal
* Urine protein ≤ 1+ by urinalysis OR \< 1 g of protein by 24-hour urine collection
* Calcium \< 12 mg/dL
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No other prior malignancy (except for basal cell or squamous cell carcinoma of the skin, in situ cervical carcinoma, or superficial transitional cell bladder carcinoma) diagnosed and/or treated within the past 3 years
* No known Gilbert's disease
* No clinically significant hearing loss
* No known hypersensitivity to bevacizumab or other study drugs
* No severe comorbid conditions, including any of the following:

  * Severe uncontrolled diabetes
  * Prior stroke or cerebrovascular disease
  * Uncontrolled infection
  * Nonmalignant illness that precludes study treatment
* No history of serious systemic disease, including any of the following:

  * Myocardial infarction within the past 6 months
  * Uncontrolled hypertension (i.e., blood pressure \> 160/110 mm Hg on medication)
  * Unstable angina
  * New York Heart Association class II-IV congestive heart failure
  * Unstable symptomatic arrhythmia requiring medication

    * Chronic atrial arrhythmia (i.e., atrial fibrillation or paroxysmal supraventricular tachycardia) allowed
  * Peripheral vascular disease ≥ grade 2
* No significant traumatic injury within the past 28 days
* No evidence of bleeding diathesis or coagulopathy
* No other concurrent medical or psychiatric condition or disease that would preclude study participation

PRIOR CONCURRENT THERAPY:

* No prior radiotherapy
* Recovered from prior oncologic or other major surgery
* No major surgery or open biopsy within the past 28 days
* No fine-needle aspiration or core biopsies within the past 7 days
* At least 1 week since prior and no concurrent participation in another experimental drug study (unless Genentech sponsored)
* No other concurrent major surgery
* No other concurrent chemotherapy
* No concurrent sargramostim (GM-CSF)
* No concurrent phenytoin, carbamazepine, barbiturates, rifampin, phenobarbital, Hypericum perforatum (St. John's wort), or other antiepileptic medication