A Multicenter, Phase III, Randomized, Placebo-Controlled Trial Evaluating the Efficacy and Safety of Bevacizumab in Combination With Chemotherapy Regimens in Subjects With Previously Untreated Metastatic Breast Cancer
Inclusion Criteria:
- Histologically or cytologically confirmed adenocarcinoma of the breast, with
measurable or non-measurable locally recurrent or metastatic disease
- Signed Informed Consent Form
- Age >/= 18 years
- For women of childbearing potential, use of accepted and effective method of
non-hormonal contraception
- ECOG performance status of 0 or 1
- Ability and capacity to comply with study and follow-up procedures
- For anthracycline cohort only: adequate left ventricular function at study entry,
defined as an LVEF >/= 50% by either MUGA scan or ECHO.
- For subjects who have received recent radiation therapy: recovery prior to Day 0 from
any significant (Grade >/= 3) acute toxicity
Exclusion Criteria:
- Unknown HER2 status or known HER2-positive status
- Prior chemotherapy for locally recurrent or metastatic disease
- Prior hormonal therapy less than 1 week prior to Day 0
- Prior adjuvant or neoadjuvant chemotherapy within 12 months prior to Day 0
- For anthracycline cohort only: Prior anthracycline as part of neoadjuvant or adjuvant
therapy for localized breast cancer
- Investigational therapy within 28 days of Day 0
- Major surgical procedure, open biopsy, or significant traumatic injury within 28 days
prior to Day 0, or anticipation of need for major surgical procedure during the
course of the study
- Minor surgical procedures, such as fine needle aspirations or core biopsies, within 7
days prior to Day 0
- Prior therapy with bevacizumab, sorafenib, sunitinib, or other VEGF pathway-targeted
therapy
- Known brain or other CNS metastases
- Blood pressure of > 150/100 mm Hg
- Unstable angina
- New York Heart Association (NYHA) Grade II or greater CHF
- History of myocardial infarction within 6 months prior to Day 0
- History of stroke or transient ischemic attack within 6 months prior to Day 0
- Clinically significant peripheral vascular disease
- Evidence of bleeding diathesis or coagulopathy
- History of abdominal fistula, gastrointestinal perforation, or intra-abdominal
abscess within 6 months prior to Day 0
- Serious non-healing wound, ulcer, or bone fracture
- Pregnancy (positive serum pregnancy test) or lactation
- Inadequate organ function, as evidenced by any of the following laboratory values:
Absolute neutrophil count < 1500/uL; Platelet count < 100,000/uL; Total bilirubin >
1.5 mg/dL; Alkaline phosphatase, AST, and/or ALT > 2x upper limit of normal (> 5x ULN
in subjects with known liver or, for alkaline phosphatase elevations, bone
involvement); Alkaline phosphatase > 2x ULN (> 7x ULN in subjects with known bone
involvement); Serum creatinine > 2.0 mg/dL; PTT and/or either INR or PT > 1.5x upper
limit of normal (except for subjects receiving anti-coagulation therapy); Urine
protein/creatinine ratio > 1.0 at screening for U.S. subjects, or urine dipstick for
proteinuria >/= 1+ at screening followed by 24-hour urine collection demonstrating >
1 g protein/24 hr for ex-U.S. subjects
- Uncontrolled serious medical or psychiatric illness
- Active infection requiring intravenous (IV) antibiotics at Day 0
- History of other malignancies within 5 years of Day 0 except for tumors with a
negligible risk for metastasis or death, such as adequately controlled basal cell
carcinoma or squamous-cell carcinoma of the skin or carcinoma in situ of the cervix
(subjects with a history of bilateral breast cancer will be eligible)