BLP25 Liposome Vaccine and Bevacizumab After Chemotherapy and Radiation Therapy in Treating Patients With Newly Diagnosed Stage IIIA or Stage IIIB Non-Small Cell Lung Cancer That Cannot Be Removed by Surgery

DISEASE CHARACTERISTICS:

• Histologically confirmed newly diagnosed nonsquamous cell non-small cell lung cancer (NSCLC), including the following subtypes:

  • Adenocarcinoma
  • Large cell undifferentiated
  • Bronchoalveolar cell
  • NSCLC, not otherwise specified

• Unresectable stage IIIA or stage IIIB disease

  • Patients with stage IIIA disease with mediastinal lymph node enlargement between 1 cm and 2.0 cm on CT scan must have these nodes biopsied (pathologic confirmation) to rule out resectability
  • Metastases to contralateral mediastinal or supraclavicular nodes allowed
• Measurable or non-measurable disease, as defined by RECIST criteria

• No significant pleural effusion as defined by either of the following:

  • Pleural effusion is seen on CT scan only (not seen on chest x-ray)
  • Pleural effusion does not reaccumulate within 1 week after thoracentesis AND is cytologically negative
• No CNS metastases by head CT scan or MRI within the past 4 weeks

PATIENT CHARACTERISTICS:

• ECOG performance status 0-1
• WBC ≥ 4,000/mm³ OR ANC ≥ 2,000/mm³
• Platelet count ≥ 140,000/mm³
• Hemoglobin ≥ 9.0 g/dL
• Total bilirubin ≤ 1.5 mg/dL
• AST/ALT ≤ 2.5 times upper limit of normal
• Serum creatinine ≤ 1.5 mg/mL OR creatinine clearance ≥ 45 mL/min
• Urine protein:creatinine ratio < 1.0 by urine dipstick OR < 1 g of protein by 24-hour urine collection
• INR ≤ 1.5 OR ≤ 3.0 if patient is on therapeutic anticoagulation
• PTT normal
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception before, during, and for ≥ 6 months after completion of bevacizumab
• No other active malignancies
• No known hepatitis B or C
• No ongoing (lasting > 14 days) or active infection or ongoing (lasting > 14 days) fever within the past 6 months

• No gross hemoptysis ≥ grade 2 (defined as ≥ ½ teaspoon of bright red blood per episode) within the past 3 months

  • No pulmonary hemoptysis

    • Confirmed extrapulmonary hemoptysis allowed
• No bleeding ≥ grade 2 or any bleeding requiring intervention
• No history of bleeding diathesis or coagulopathy

• No cardiac dysfunction, including any of the following:

  • Clinically significant cardiovascular disease
  • Myocardial infarction within the past 6 months
  • New York Heart Association class III-IV congestive heart failure
  • Unstable angina pectoris
  • Serious cardiac arrhythmia requiring medication within the past 4 weeks
  • History of hypertensive crisis or hypertensive encephalopathy
  • Stroke or transient ischemic attack within the past 6 months
  • Peripheral vascular disease ≥ grade 2 within the past 6 months
• No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months
• No psychiatric illness or social situation that would limit compliance with study requirements
• No history of uncontrolled hypertension (i.e., blood pressure ≥ 150/100 mm Hg) while on stable regimen of antihypertensive therapy
• No significant traumatic injury or serious non-healing wound, ulcer, or bone fracture within the past 4 weeks
• No recognized immunodeficiency disease, including cellular immunodeficiencies, hypogammaglobulinemia or dysgammaglobulinemia, or hereditary or congenital immunodeficiencies
• No pre-existing medical condition requiring chronic steroids or immunosuppressive therapy
• No autoimmune disease
• No known hypersensitivity to any component of bevacizumab

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• More than 4 weeks since prior open biopsy or major surgical procedure
• More than 28 days since prior immunotherapy (e.g., interferon, interleukin, sargramostim [GM-CSF], or filgrastim [G-CSF])
• Patients must not have had prior chemotherapy or monoclonal antibodies for other cancers within 5 years prior to registration
• More than 7 says since prior core biopsy or any other minor surgical procedure, excluding the placement of a vascular access device
• No prior chemotherapy for lung cancer
• No prior chest radiotherapy
• No prior splenectomy
• Concurrent stable regimen of therapeutic anticoagulation or prophylactic anticoagulation for venous access devices allowed provided coagulation studies met entry criteria
• No concurrent daily aspirin (> 325 mg/day) or nonsteroidal anti-inflammatory agents (NSAIDs) known to inhibit platelet function
• No concurrent dipyridamole (Persantine), ticlopidine (Ticlid), clopidogrel bisulfate (Plavix), and/or cilostazol (Pletal)
• No concurrent major surgical procedure