Bevacizumab and Erlotinib in Treating Patients With Recurrent or Metastatic Head and Neck Cancer

Inclusion Criteria: Histologically or cytologically confirmed squamous cell cancer of the head and neck Recurrent or metastatic disease Determined to be incurable by surgery or radiotherapy Measurable disease No tumor involvement encasing or too close in proximity to a major artery or vein No known brain metastases No prior or concurrent CNS disease No primary brain tumor Performance status - ECOG 0-2 Performance status - Karnofsky 60-100% More than 12 weeks No history of bleeding diathesis WBC at least 3,000/mm^3 Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 INR less than 1.5 Bilirubin normal AST and ALT no greater than 2.5 times upper limit of normal Creatinine normal Creatinine clearance at least 60 mL/min No significant renal impairment 24-hour urinary protein less than 0.5 g required if more than trace proteinuria at baseline No uncontrolled hypertension No symptomatic congestive heart failure No serious cardiac arrhythmia requiring medication No deep venous thrombosis No prior stroke No New York Heart Association class II-IV heart disease No grade II-IV peripheral vascular disease within the past year No arterial thromboembolic event within the past 6 months, including any of the following: Unstable angina pectoris Myocardial infarction Transient ischemic attack Cerebrovascular accident No clinically significant peripheral artery disease No significant ophthalmologic abnormalities* including any of the following: Severe dry eye syndrome Keratoconjunctivitis sicca Sjögren's syndrome Severe exposure keratopathy Disorders that might increase the risk for epithelium-related complications (e.g., bullous keratopathy, aniridia, severe chemical burns, neutrophilic keratitis) Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No prior allergic reactions to compounds of similar chemical or biologic composition to bevacizumab or other study agents No known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies No significant traumatic injury within the past 28 days No other concurrent uncontrolled illness No psychiatric illness or social situation that would preclude study compliance No ongoing or active infection requiring parenteral antibiotics No serious non-healing wound ulcer or bone fracture No seizures not controlled by standard medical therapy More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) More than 4 weeks since prior radiotherapy More than 4 weeks since prior major surgery More than 4 weeks since prior open biopsy Recovered from prior therapy No more than 1 prior regimen for recurrent disease No prior epidermal growth factor receptor (EGFR)-based therapy for recurrent disease No prior vascular EGFR-based therapy for recurrent disease No other concurrent investigational agents No other concurrent anticancer agents or therapies No concurrent combination antiretroviral therapy for HIV-positive patients No concurrent chronic use of aspirin (325 mg/day or more) or other nonsteroidal anti-inflammatory drugs No concurrent warfarin or heparin, including low-molecular weight heparin No other concurrent or recent (within 1 month) thrombolytic agents or full-dose anticoagulants (except to maintain patency of preexisting, permanent indwelling IV catheters)