S0802 - Topotecan With or Without Aflibercept in Treating Patients With Extensive-Stage Small Cell Lung Cancer

Inclusion Criteria:

* Histologically or cytologically confirmed extensive stage small cell lung cancer

  * Progressive or recurrent disease following one (and only one) standard first-line platinum-containing regimen (cisplatin or carboplatin)
* Measurable or non-measurable disease per RECIST criteria

  * Disease must be outside a previously irradiated field OR a new lesion must be inside the irradiated field
  * Disease must be outside a previously resected area OR a new lesion must be present
* No known brain metastasis unless the metastasis has been treated and is stable for ≥ 3 months prior to study entry
* No leptomeningeal involvement or brain stem metastasis
* Zubrod performance status 0-1
* ANC ≥ 1,500/mm\^3
* Platelet count ≥ 100,000/mm\^3
* Hemoglobin ≥ 10 g/dL
* Serum creatinine ≤ 1.5 times upper limit of normal OR creatinine clearance ≥ 60 mL/min
* Urine protein: creatinine ratio \< 1 OR urine protein \< 500 mg by 24-hour urine collection
* Not pregnant or nursing
* Fertile patients must use effective contraception
* Willing to provide smoking history
* No evidence of active infection
* No active bleeding
* No significant history of bleeding diathesis, including hemoptysis (½ teaspoon of hemoptysis within the past 3 months), or underlying coagulopathy
* No history of recent arterial embolic events, including any of the following:

  * Myocardial infarction
  * Cerebrovascular accident
  * Transient ischemic attack
  * Worsening of pre-existing angina within the past 6 months
* No uncontrolled hypertension (systolic BP \> 150 mm Hg or diastolic BP \> 100 mm Hg)

  * History of hypertension allowed provided it is controlled on anti-hypertensive medications
* No history of congestive heart failure
* No history of encephalitis or encephalopathy of any cause
* No diverticulitis, gastrointestinal bleeding, or peptic ulcer within the past 3 months
* No known AIDS or HIV-1 associated complex
* No known history of immune or immunodeficiency disorders
* No unstable or pre-existing major medical conditions except for cancer-related abnormalities
* No other prior malignancy except for any of the following:

  * Adequately treated basal cell or squamous cell skin cancer
  * In situ cervical cancer
  * Adequately treated stage I or II cancer currently in complete remission
  * Any other cancer from which the patient been disease-free for 5 years
* Concurrent chronic therapeutic doses of low molecular weight heparin allowed
* At least 21 days since prior and no concurrent radiotherapy and recovered
* At least 28 days since prior and no concurrent surgery (e.g., thoracic or other major surgeries) and recovered
* No prior bevacizumab or other anti-angiogenic therapies including, but not limited to, small molecule tyrosine kinase inhibitors
* No concurrent enzyme-inducing anticonvulsant drugs

  * Non-enzyme-inducing anticonvulsant drugs (e.g., Keppra) allowed
* Concurrent chronic oral anticoagulation therapy allowed provided INR is maintained in the therapeutic range (INR 2-3)