Bevacizumab and Erlotinib in Treating Patients With Advanced Liver Cancer

Inclusion Criteria: Absolute neutrophil count >= 1,500/mm^3 Creatinine =< 2 mg/dL Albumin >= 2.5 g/dL Total bilirubin =< upper limit of normal (ULN) aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 2.5 times ULN Alkaline phosphatase =< 5 times ULN Urine protein:creatinine ratio < 1.0 OR 24-hour urine protein < 1,000 mg Not pregnant or nursing: No nursing for >= 6 months after completion of study treatment Negative pregnancy test Fertile patients must use effective contraception during study and for >= 6 months after completion of study treatment No history of allergic reactions attributed to compounds of similar chemical or biological composition to bevacizumab or erlotinib hydrochloride No abnormalities of the cornea, including any of the following: History of dry eye syndrome or Sjögren's syndrome; Congenital abnormality (e.g., Fuch's dystrophy); Abnormal slit-lamp examination using a vital dye (e.g., fluorescein, Bengal-Rose); Abnormal corneal sensitivity test (e.g., Schirmer test or similar tear production test) No stroke or transient ischemic attack within the past 6 months No uncontrolled high blood pressure, history of labile hypertension, or history of poor compliance with an antihypertensive regimen No unstable angina pectoris within the past 6 months No symptomatic congestive heart failure No myocardial infarction within the past 6 months No serious uncontrolled cardiac arrhythmias No uncontrolled diabetes mellitus No active or uncontrolled infection No impaired GI function or disease that may significantly alter the absorption of erlotinib hydrochloride (e.g., ulcerative disease, uncontrolled nausea, vomiting, or diarrhea, malabsorption syndrome, or bowel obstruction) Able to swallow tablets No psychiatric illness or social situation that would limit compliance with study requirements No history of nephrotic-range protein No history of bleeding diathesis No encephalopathy No serious nonhealing wounds, skin ulcers, or bone fractures No clinically significant peripheral vascular disease No known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies No history of a GI bleed that required procedural intervention (e.g., variceal banding, surgical shunt, transvenous intrahepatic porto-systemic shunt [TIPS]) within the past 3 months No significant traumatic injury within the past 28 days No other prior malignancy within the past 5 years except for the following: Adequately treated basal cell or squamous cell skin cancer; Adequately treated in situ cervical cancer; Stage I or II cancer from which the patient is currently in complete remission; Stage I chronic lymphocytic leukemia Recovered from all therapy-related toxicities No more than 1 prior systemic or liver directed drug therapy including transarterial chemoembolization (TACE) (multiple TACEs will count as 1 prior regimen irrespective of their total numbers) that were used for HCC No chemotherapy for HCC within the past 4 weeks (6 weeks for nitrosoureas or mitomycin C) No biological therapy or immunotherapy for HCC within the past 4 weeks Prior surgery, regional therapy (e.g., transarterial embolization), liver transplantation, or other liver-directed ablative therapies of discrete lesions allowed provided any related progressive or recurrent disease is documented No cryotherapy, radiofrequency ablation, ethanol injection, or photodynamic therapy within the past 6 weeks: Indicator lesions must be outside the area of prior treatment OR if the lesion is inside the area of prior treatment, there must be clear evidence of disease progression associated with that lesion No core biopsy within the past 7 days No radiotherapy within the past 4 weeks No prior antiangiogenesis agent or antiepidermal growth factor receptor drug No prior treatment with hepatic arterial infusion with chemotherapy or yttrium Y 90-labeled microspheres No other concurrent investigational agents No concurrent combination antiretroviral therapy for HIV-positive patients No other concurrent anticancer therapy Concurrent full-dose anticoagulants (e.g., warfarin) with international normalized ratio (INR) > 1.2 allowed provided the following criteria are met: An in-range INR (usually between 2 and 3) on a stable dose of oral anticoagulant (or on a stable dose of low molecular weight heparin) AND (continued from above) No active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels, gastrointestinal [GI] ulceration, or known varices) No concurrent major surgical procedures Histologically confirmed hepatocellular carcinoma (HCC): No fibrolamellar subtype HCC Advanced disease Not a candidate for surgical resection or liver transplantation Measurable disease: Edges of the indicator lesion must be clearly distinct on CT scan Lesions that measure at least 1 cm but less than 2 cm only must use spiral CT imaging for both pre- and post-treatment tumor assessments Child's Pugh classification A or B No primary brain tumor, brain metastasis, or other central nervous system (CNS) diseases Eastern Cooperative Oncology Group (ECOG) performance status 0-1 Platelet count >= 75,000/mm^3 No major surgery (e.g., laparotomy), open biopsy, or minor surgery (e.g., insertion of a vascular access device) within the past 4 weeks No interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the lung No abdominal fistula, GI perforation, or intra-abdominal abscess within the past 28 days No concurrent prophylactic hematopoietic colony-stimulating factors