Biweekly Intraperitoneal Oxaliplatin with Systemic Capecitabine and Bevacizumab for Patients with Peritoneal Carcinomatosis from Appendiceal or Colorectal Cancer

Inclusion Criteria

• Patients must have a histologically documented peritoneal carcinomatosis from either colorectal or appendiceal adenocarcinoma
• Patients must have undergone debulking surgery with peritonectomy and have been allowed at least 4 weeks to recover prior to receiving chemotherapy
• Intraperitoneal ports may be placed during or at any time separate from surgical debulking; provided the patient has been allowed at least 4 weeks to recover from surgical debulking, no additional recovery time is required for port placement
• Patients must undergo a peritoneal scan documenting at least one working intraperitoneal port prior to receiving chemotherapy
• Patients may have received prior chemotherapy
• Eastern Cooperative Oncology Group (ECOG) 0-2
• Patients must have recovered from uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or cardiac arrhythmias
• All patients must be consented prior to chemotherapy; the patient should not have any serious medical or psychiatric illness that would prevent either the giving of informed consent or the receipt of treatment
• Absolute neutrophil count >= 1,500/mm^3
• Platelet count >= 100,000/mm^3
• Hemoglobin >= 8 g/dl
• Total bilirubin must be < 2 x institutional upper limit of normal (ULN)
• Transaminases (serum glutamic oxaloacetic transaminase [SGOT] and/or serum glutamate pyruvate transaminase [SGPT]) must be =< 3 x upper limit of normal (ULN)
• Alkaline phosphatase must be =< 4 x the institutional upper limit of normal (ULN)
• Serum creatinine =< 2.0 mg/dl or creatinine clearance >= 60 ml/min/1.73 m^2 for patients with creatinine levels above 2.0 mg/dl

Exclusion Criteria

• Pregnant or breast feeding; for all sexually active patients, the use of adequate contraception (hormonal or barrier method of birth control) will be required during therapy, prior to study entry, and for the duration of study participation; non-pregnant status will be determined in all women of childbearing potential
• Prior history of hypersensitivity reactions to oxaliplatin, bevacizumab, fluorouracil (5-FU) or capecitabine
• Gastrointestinal ailments that may alter the absorption of oral medications (i.e. bowel obstruction, short-gut syndrome)
• Patients receiving antiretroviral therapy (highly active antiretroviral therapy [HAART]) for human immunodeficiency virus (HIV) infection are excluded from the study because of possible pharmacokinetic interactions
• Patients with grade 2 or higher peripheral neuropathy