Trial Information

Phase II Trial of Trastuzumab (Herceptin), Bevacizumab, and Docetaxel (Taxotere) Trial in Stage IV Metastatic Breast Cancer (MBC) Patients

Rationale: Antibodies are proteins that are normally part of the immune system that bind to
foreign agents in the body. Researchers manufacture antibodies outside of the human body
that bind to specific targets such as proteins in cancer cells. Herceptin is a monoclonal
antibody that binds to the human epidermal growth factor receptor (HER-2), and can kill
HER2-positive cancer cells. Herceptin is used to treat breast cancer that is HER2-positive,
and has spread after treatment with other drugs. Bevacizumab is a signal transduction
inhibitor that works by preventing the growth of new blood vessels from surrounding tissue
into tumors. Bevacizumab specifically inhibits the vascular endothelial growth factor
(VEGF), a substance made by cells that stimulates new blood vessel formation. Research
indicates that HER-2 signaling helps to induce VEGF expression. Therefore, cancer treatments
targeting both HER-2 and VEGF may improve anti-cancer efficacy in patients. Docetaxel is a
chemotherapy agent used against breast and other types of cancer. The current study builds
on previous research suggesting the safety and potential for efficacy with combination
trastuzumab, bevacizumab, and docetaxel.

Purpose: The primary objectives are to determine the progression free survival and evaluate
the safety of trastuzumab, bevacizumab, and docetaxel. Secondary objectives are to assess
early changes in circulating tumor cells and circulating endothelial cells as predictors of
progression free survival and clinical benefit, as well as to determine the overall clinical
benefit rate.

Treatment: Study participants will be given trastuzumab, bevacizumab, and docetaxel. All
study drugs will be given through intravenous infusions once every 21 days. A cycle is
considered 3 weeks. A minimum of 6 study treatment cycles is required unless study
participants experience disease growth or intolerable toxicity. The decision to stop
docetaxel after 6 cycles is up to the discretion of the treating physician and the patient.
Study participants who are deriving a benefit from the study drugs may continue on
trastuzumab and bevacizumab alone. Several tests and exams will be given throughout the
study to closely monitor study participants.