A Multi-Institutional, Open-Label, Phase II Study Of Doxorubicin And Bevacizumab (Anti-VEFG Monoclonal Antibody, NSC 704865) For Patients With Advanced Or Metastatic Soft-Tissue Sarcoma
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed soft tissue sarcoma
- Locally recurrent or metastatic disease
- At least 1 unidimensionally measurable lesion
- At least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan
- No prior or concurrent known brain metastases
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- Karnofsky 80-100% OR
- ECOG 0-1
Life expectancy
- Not specified
Hematopoietic
- Absolute neutrophil count at least 1,500/mm^3
- Platelet count at least 100,000/mm^3
- No bleeding diathesis or coagulopathy
Hepatic
- Bilirubin no greater than 1.2 mg/dL
- AST and ALT no greater than 2.5 times upper limit of normal
- PT and aPTT normal
Renal
- Creatinine no greater than 1.5 mg/dL OR
- Creatinine clearance at least 60 mL/min
- No proteinuria (must be less than 500 mg protein per 24 hours)
Cardiovascular
- Cardiac ejection fraction at least 50% by echocardiogram or MUGA
- No history of deep vein thrombosis
- No clinically significant cardiovascular disease
- No uncontrolled hypertension
- No myocardial infarction
- No unstable angina
- No New York Heart Association grade II-IV congestive heart failure
- No serious cardiac arrhythmia requiring medication
- No grade II or greater peripheral vascular disease within the past year
Pulmonary
- No history of pulmonary embolism
Other
- No symptomatic peripheral neuropathy grade 2 or greater
- No other neoplastic disease within the past 5 years except curatively treated basal
cell skin cancer or carcinoma in situ of the cervix
- No prior allergic reactions attributed to compounds of similar chemical or biological
composition to bevacizumab (including products derived from Chinese hamster ovary
cells), doxorubicin, or dexrazoxane
- No HIV-positive patients receiving combination antiretroviral therapy
- No ongoing or active infection
- No psychiatric illness or social situations that would preclude study entry
- No other uncontrolled concurrent illness
- No serious, non-healing wound ulcer or bone fracture
- No significant traumatic injury within the past 3 weeks
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
Biologic therapy
- See Chemotherapy
- At least 4 weeks since prior immunotherapy and recovered
- No other concurrent immunotherapy
Chemotherapy
- No prior doxorubicin or any other anthracyclines
- No more than 1 prior chemotherapy regimen
- The following are not considered prior chemotherapy:
- Immunotherapy, including cytokines
- Peroxisome-proliferator-activated receptor gamma agonists or thalidomide
- At least 4 weeks since prior chemotherapy (6 weeks for carmustine or mitomycin) and
recovered
- No other concurrent chemotherapy
Endocrine therapy
- Not specified
Radiotherapy
- At least 4 weeks since prior radiotherapy and recovered
- No concurrent radiotherapy
Surgery
- At least 3 weeks since prior major surgical procedure or open biopsy
- At least 1 week since prior needle biopsy
Other
- No other concurrent investigational agents
- No concurrent full-dose anticoagulants (except to maintain patency of preexisting,
permanent indwelling IV catheters) or thrombolytic agent
- Concurrent warfarin allowed if INR less than 1.5
- No concurrent chronic daily aspirin (more than 325 mg/day) or nonsteroidal anti
-inflammatory medications known to inhibit platelet function
- No other concurrent investigational or commercial agents or therapies for this
malignancy