Phase II Trial of Pre-operative Bevacizumab and FOLFOX Chemotherapy in Locally Advanced Esophageal Cancer
This pilot phase II trial studies how well giving bevacizumab and combination chemotherapy together before surgery works in treating patients with locally advanced esophageal or stomach cancer. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Drugs used in chemotherapy, such as leucovorin calcium, fluorouracil, and oxaliplatin work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving bevacizumab and combination chemotherapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed. Giving these treatments after surgery may kill any tumor cells that remain after surgery.
• Patients must have biopsy proven adenocarcinoma, squamous cell carcinoma or undifferentiated carcinoma of the esophagus, GE junction and/or gastric cardia
• Patients must have potentially resectable disease by the thoracic, minimally invasive or transhiatal approach
‣ No portion of the lesion may be within 5 cm of the cricopharyngeus
⁃ Patient must be considered medically fit for surgery with average or below average risk
⁃ T1-3 or T4 with local invasion confined to diaphragm, pleura or pericardium
⁃ No myocardial infarction within 12 months of enrollment
• Patients must have Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
• White blood cells (WBC) \>= 3,500/mm\^3
• Platelet count \>= 100,000/mm\^3
• Serum creatinine (Cr) =\< 1.5 mg and/or creatinine clearance \>= 60 cc/min
• Bilirubin must be \< upper limit of normal (ULN) unless the patient has a chronic grade 1 bilirubin elevation due to Gilbert's disease or similar syndrome due to slow conjugation of bilirubin
• Alkaline phosphatase must be \< ULN
• Aspartate aminotransferase (AST) \& alanine aminotransferase (ALT) must be \< ULN
• Urine protein/creatinine (UPC) ratio of \< 1.0 or dipstick for protein of \< 2+, Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v 4) grade \< 2; patients with a UPC ratio \>= 1.0 or dipstick of 2+ must undergo a 24-hour urine collection and must demonstrate \< 1 gm of protein in order to participate
• Patients must give written informed consent and Health Insurance Portability and Accountability Act (HIPAA) consent