Pembrolizumab, Bevacizumab, and Cyclophosphamide in Treating Patients With Recurrent Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

Inclusion Criteria

• Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
• Have measurable disease per RECIST 1.1 criteria present
• Participant may have serous, endometrioid, clear cell, mucinous or undifferentiated type of recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer
• Histologic confirmation of the original primary tumor is required via the pathology report
• Participant can be either platinum-sensitive (platinum free interval [PFI] >= 6 months prior to recent recurrence) or platinum-resistant (PFI = 1,500 /mcL
• Platelets: >= 100,000 / mcL
• Hemoglobin: >= 9 g/dL or 5.6 mmol/L without transfusion or erythropoietin (EPO) dependency (within 7 days of assessment)
• Serum creatinine: = = 60 mL/min for participant with creatinine levels > 1.5 X institutional ULN; glomerular filtration rate (GFR) can also be used in place of creatinine or creatinine clearance (CrCl)
• Urine protein creatine ratio (UPCR) 1.5 ULN
• Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase[SGOT]) and alanine transaminase (ALT) (serum glutamic pyruvic transaminase [SGPT]): = 2.5 mg/dL
• International normalized ratio (INR) or prothrombin time (PT): = 1 year); should a woman become pregnant or suspect she is pregnant while she is participating in this study, she should inform her treating physician immediately
• Participant has recovered from toxicities of prior chemotherapy or other therapy (to grade 2 or less)
• Participant may have received prior investigational therapy (including immune therapy)
• Participant may have received prior hormonal therapy
• Participant may have received bevacizumab (or other antiangiogenic agent) and/or cyclophosphamide in the past
• Participant has had at least 4 weeks of postoperative recovery from surgery prior to enrollment to ensure complete wound healing; participants with bowel resections at surgery should begin protocol at least 42 days after surgery
• Ability to swallow and retain oral medication
• Participant or legal representative must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure

Exclusion Criteria

• Is currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of treatment
• Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment or, is taking any other medication that might affect immune function
• Has a known history of active bacillus tuberculosis (TB)
• Hypersensitivity to bevacizumab, cyclophosphamide, pembrolizumab or any of its excipients
• Has had a prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to study day 1 or who has not recovered (i.e., = 150 mmHg or diastolic > 90 mmHg
• Myocardial infarction or unstable angina within 6 months prior to enrollment
• New York Heart Association (NYHA) grade II or greater congestive heart failure
• Participant has a grade II or greater peripheral vascular disease
• Participant has a clinically significant peripheral artery disease (e.g. those with claudication, within 6 months)
• Participant has organ allografts
• Participant is receiving medication(s) that might affect immune function
• Unwilling or unable to follow protocol requirements