Bevacizumab and Combination Chemotherapy in Treating Patients With Metastatic Colorectal Cancer

DISEASE CHARACTERISTICS:

* Histologically confirmed adenocarcinoma of the colon or rectum

  * Previously untreated metastatic disease
* Measurable disease by RECIST

  * Must not be located in a prior radiation field
* No cerebral or meningeal metastases

PATIENT CHARACTERISTICS:

Inclusion criteria:

* WHO performance status 0-1
* Life expectancy \> 12 weeks
* Absolute neutrophil count ≥ 1,000/mm³
* Platelet count ≥ 100,000/mm³
* Bilirubin ≤ 1.5 times upper limit of normal (ULN)
* Transaminases ≤ 2 times ULN (5 times ULN if liver metastases present)
* Alkaline phosphatase ≤ 2 times ULN (5 times ULN if liver metastases present)
* Creatinine ≤ 130 μmol/L OR creatinine clearance ≥ 30 mL/min
* Proteinuria \< 2+ or urine protein ≤ 1 g/24 hours
* Not pregnant or nursing
* Fertile patients of must use effective contraception

Exclusion criteria:

* Uncontrolled cardiac disease
* Prior cerebral vascular accident
* Uncontrolled arterial hypertension
* Severe renal or hepatic insufficiency
* Prior arteriopathy
* Bleeding disorder or nonhealing wound
* Coagulopathy
* Other malignancy within the past 2 years except basal cell or squamous cell skin cancer or curatively treated carcinoma of the cervix
* Psychiatric disorder compromising comprehension or participation in the study
* Intestinal occlusion or subocclusion not caused by medical therapy

PRIOR CONCURRENT THERAPY:

Inclusion criteria:

* See Disease Characteristics

Exclusion criteria:

* Prior adjuvant bevacizumab or irinotecan hydrochloride
* Concurrent aspirin (\> 325 mg/day) or therapeutic anticoagulants
* Surgery in the past 28 days