Safety and Efficacy Trial of Bevacizumab: Anti-VEGF Humanized Monoclonal Antibody (NSC 704865) Therapy for Myelodysplastic Syndrome (MDS)
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically confirmed myelodysplastic syndrome (MDS)
- Refractory anemia (RA)
- RA with excess blasts (RAEB)
- RAEB in transformation
- RA with ringed sideroblasts
- Non-proliferative chronic myelomonocytic leukemia (WBC less than 12,000/mm^3)
- At least 1 of the following cytopenias:
- Untransfused hemoglobin no greater than 10.0 g/dL and/or red cell transfusion
dependent
- Absolute neutrophil count no greater than 1,800/mm^3 (neutropenia)
- Platelet count no greater than 100,000/mm^3 (thrombocytopenia)
- No secondary MDS
- No known brain metastases
PATIENT CHARACTERISTICS:
Age:
- 18 and over
Performance status:
- ECOG 0-2
- Karnofsky 60-100%
Life expectancy:
- More than 4 months
Hematopoietic:
- See Disease Characteristics
- Platelet count at least 20,000/mm^3
- No hemorrhagic illness within the past 3 weeks
- No hemolysis
- No iron deficiency
- No active blood loss
Hepatic:
- AST and ALT no greater than 2.5 times upper limit of normal (ULN)
- Bilirubin no greater than 2.0 mg/dL
- INR less than 2.0
- PTT less than 1.5 times ULN
Renal:
- Creatinine no greater than 2.0 mg/dL
- No renal dysfunction requiring dialysis within the past 6 months
- No nephrotic syndrome within the past 6 months
Cardiovascular:
- No myocardial infraction within the past 6 months
- No severe or unstable angina within the past 6 months
- No severe peripheral vascular disease (ischemic rest pain, non-healing wound or
ulcer, or tissue loss) within the past 6 months
- No uncontrolled hypertension within the past 6 months
- No transient ischemic attack within the past 6 months
- No cerebrovascular accident within the past 6 months
- No deep venous or arterial thrombosis
- No coronary artery disease
- No symptomatic congestive heart failure (New York Heart Association class II-IV heart
disease)
- No cardiac arrhythmia
- No vascular illness within the past 3 weeks
Pulmonary:
- No pulmonary embolism
Other:
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No other active malignancy except localized squamous cell or basal cell skin cancer
- Prior cured malignancy allowed
- No trauma within the past 3 weeks
- No significant inflammatory disease within the past 3 weeks
- No serious non-healing wound, ulcer, or bone fracture
- No hypersensitivity to Chinese hamster ovary cell products or other recombinant human
or humanized antibodies
- No other active severe disease
- No infection
- No psychiatric illness or social situation that would preclude study compliance
- HIV negative
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- No prior allogeneic bone marrow transplantation
- At least 30 days since prior biologic response modifiers
- At least 30 days since prior hematopoietic growth factors
- At least 30 days since prior thalidomide
- No concurrent thalidomide
- No other concurrent biologic response modifiers
- No concurrent hematopoietic growth factors (including epoetin alfa)
- Concurrent filgrastim (G-CSF) for febrile neutropenia allowed
- Concurrent transfusions allowed
Chemotherapy:
- At least 30 days since prior chemotherapy
- No concurrent chemotherapy
Endocrine therapy:
- No concurrent corticosteroid therapy (more than 10 mg/day of prednisone or equivalent
steroid dose) except for pre-medication for transfusions
Radiotherapy:
- At least 30 days since prior radiotherapy
- No concurrent radiotherapy
Surgery:
- At least 3 weeks since prior surgery (including biopsy of visceral organ)
Other:
- At least 10 days since prior anticoagulants
- No concurrent cytotoxic agents
- No other concurrent investigational agents