Bevacizumab and Low-Dose Cyclophosphamide in Treating Patients With Recurrent Ovarian Epithelial or Primary Peritoneal Cancer

Inclusion Criteria

• Histologically confirmed recurrent or metastatic ovarian epithelial or primary peritoneal cancer
• Unidimensionally measurable disease
• Previously irradiated indicator lesions must have progressed after radiotherapy
• Received a platinum-containing regimen for primary disease
• No more than 2 prior chemotherapy regimens for recurrent disease
• Must have received prior platinum-based chemotherapy for recurrent disease if it has been > 12 months since treatment for primary disease (except if hypersensitivity to platinum has developed)
• Rechallenge with the same platinum-based regimen is considered 1 prior regimen
• No history or clinical evidence of CNS disease, including primary brain tumor
• No brain metastases
• Performance status - SWOG 0-2
• At least 3 months
• Absolute neutrophil count at least 1,500/mm^3
• Platelet count at least 100,000/mm^3
• No bleeding diathesis
• No coagulopathy
• Bilirubin no greater than 1.5 times normal
• ALT or AST no greater than 3 times upper limit of normal
• INR less than 1.5 (for patients receiving warfarin)
• Creatinine no greater than 1.5 times normal
• No proteinuria (less than 1+)
• Proteinuria less than 500 mg/24-hour urine collection
• No prior deep vein thrombosis
• No prior stroke
• No clinically significant cardiovascular disease
• None of the following within the past year:
• Uncontrolled hypertension
• New York Heart Association class II-IV congestive heart failure
• Serious cardiac arrhythmia requiring medication
• Grade II or greater peripheral vascular disease
• None of the following within the past 6 months:
• Unstable angina
• Myocardial infarction
• Transient ischemic attack
• Cerebrovascular accident
• Other arterial thromboembolic event
• No clinically significant peripheral artery disease
• No active infection requiring parenteral antibiotics
• No known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies
• Not pregnant or nursing
• Fertile patients must use effective contraception
• No serious, non-healing wound, ulcer, or bone fracture
• No significant traumatic injury within the past 28 days
• No seizures not controlled with standard medical therapy
• No other malignancy within the past 5 years except nonmelanoma skin cancer or carcinoma in situ of the cervix
• All prior invasive malignancies must be in complete remission
• No other concurrent medical, psychological, or social condition that would preclude study participation
• No prior antiangiogenesis agents
• See Disease Characteristics
• Recovered from prior chemotherapy
• See Disease Characteristics
• Recovered from prior radiotherapy
• More than 28 days since prior major surgical procedure or open biopsy and recovered
• At least 3 weeks since prior therapy directed at the malignancy
• No recent or concurrent full-dose anticoagulants or thrombolytic agents
• Anticoagulants to maintain patency of preexisting, permanent indwelling IV catheters allowed
• No concurrent chronic daily aspirin (greater than 325 mg/day) or nonsteroidal anti-inflammatory drugs known to inhibit platelet function