Bevacizumab in Reducing CNS Side Effects in Patients Who Have Undergone Radiation Therapy to the Brain for Primary Brain Tumor, Meningioma, or Head and Neck Cancer

Inclusion Criteria

• No evidence of bleeding diathesis or coagulopathy
• Fertile patients must use effective contraception during and for >= 2 months after completion of study therapy
• No diarrhea >= grade 1
• Histologically confirmed primary brain neoplasm, meningioma, or head and neck cancer [WHO grade 2 or 3 disease--no WHO grade 4 primary brain neoplasms (i.e., glioblastoma or gliosarcoma)]
• Patients with head and neck cancer must not have any of the following:
• Evidence of metastatic disease
• Evidence of tumor invasion to major vessels (e.g., the carotid)
• History of bleeding related to tumor or radiotherapy during or after completion of radiotherapy
• Must have undergone cranial irradiation
• Must have radiographic evidence to support the diagnosis of radiation necrosis and/or surgical biopsy evidence of necrosis without tumor within the past 2 months
• Must have evidence of progressive neurologic signs or symptoms appropriate to the location of the radiation necrosis
• No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 28 days
• No significant traumatic injury within the past 28 days
• No evidence of active CNS hemorrhage
• Karnofsky performance status 60-100%
• No clinically significant cardiovascular disease, including any of the following:
• Inadequately controlled hypertension (i.e., systolic BP > 140 mm Hg and/or diastolic BP > 90 mm Hg despite antihypertensive medication)
• Large vessel cerebrovascular accident within the past 6 months
• Myocardial infarction or unstable angina within the past 6 months
• No clinically significant cardiovascular disease, including any of the following:
• NYHA class II-IV congestive heart failure
• Serious or inadequately controlled cardiac arrhythmia
• Significant vascular disease (e.g., aortic aneurysm or history of aortic dissection)
• Clinically significant peripheral vascular disease
• At least 6 months since prior radiotherapy
• Platelet count > 75,000/mm^3
• Granulocyte count > 1,500/mm^3
• Creatinine = 1 week prior to study entry
• Concurrent full-dose anticoagulants (e.g., warfarin) with PT INR > 1.5 allowed provided the following criteria are met:
• In-range INR (usually between 2 and 3) and patient is on a stable dose of oral anticoagulant for 1 week or on a stable dose of low molecular weight heparin
• No active bleeding or pathological condition that carries a high risk of bleeding
• Concurrent full-dose anticoagulants (e.g., warfarin) with PT INR > 1.5 allowed provided the following criteria are met: No evidence of serious or nonhealing wound, ulcer, or bone fracture
• No concurrent chemotherapy or tyrosine kinase inhibitors of VEGFR
• No prior bevacizumab
• More than 7 days since prior core biopsy
• History of seizures allowed provided the patient is receiving anticonvulsant therapy
• Hemoglobin >= 9.0 g/dL
• Bilirubin =< 1.5 times upper limit of normal (ULN)
• No other concurrent investigational agents