Combined Targeted Therapies for Triple Negative Advanced Breast Cancer - A Phase II Trial of Weekly Nab-Paclitaxel and Bevacizumab Followed by Maintenance Targeted Therapy With Bevacizumab and Erlotinib

Inclusion Criteria:

- Have histologically confirmed invasive breast cancer that is estrogen receptor (ER)
negative, progesterone receptor (PR) negative and human epidermal growth factor
receptor (HER)-2 non-overexpressing

- Be receiving first-line therapy for metastatic disease

- Measurable disease by Response Evaluation Criteria In Solid Tumors (RECIST) criteria;
Xrays, scans or physical examinations used for tumor measurement must have been
completed within 28 days prior to registration; Xrays, scans or other tests for
assessment of non-measurable disease must have been performed within 42 days prior to
registration

- OR Non-measurable disease only, with rising serum CA15-3 or CA 27.29 or
carcinoembryonic antigen (CEA) documented by two consecutive measurements taken at
least 14 days apart with the most recent measurement being within 42 days prior to
registration

- AND the second CA 15-3 or CA 27.29 or CEA value must have at least a 20% increase
over the first and for CA 15-3 or CA 27.29 be greater than or equal to 40 units/mL or
for CEA be greater than or equal to 4 ng/mL

- If of childbearing potential must have a negative pregnancy test and use an effective
method to avoid pregnancy for the duration of the trial and for at least 6 months
after completion of study therapy if able to bear children

- Patients must be informed of the investigational nature of this study and must sign
and give informed consent in accordance with institutional standards and federal
guidelines

Exclusion Criteria

- Recurrent disease within 12 months after completion of adjuvant chemotherapy
containing a weekly taxane

- Central nervous system (CNS) metastases

- Pre-existing nephritic syndrome

- Serious intercurrent medical or psychiatric illness including serious active
infection

- Inadequately controlled hypertension (defined as systolic blood pressure > 150 and/or
diastolic blood pressure > 100 mmHg on antihypertensive medications)

- Any prior history of hypertensive crisis or hypertensive encephalopathy

- New York Heart Association (NYHA) Grade II or greater congestive heart failure

- History of myocardial infarction or unstable angina within 6 months prior to study
enrollment

- History of stroke or transient ischemic attack within 6 months prior to study
enrollment

- Significant vascular disease (e.g., aortic aneurysm, aortic dissection)

- Symptomatic peripheral vascular disease

- Evidence of bleeding diathesis or coagulopathy

- Major surgical procedure, open biopsy, or significant traumatic injury within 28 days
prior to study enrollment or anticipation of need for major surgical procedure during
the course of the study

- Core biopsy or other minor surgical procedure, excluding placement of a vascular
access device, within 7 days prior to study enrollment

- History of abdominal fistula, gastrointestinal perforation, or intra-abdominal
abscess within 6 months prior to study enrollment

- Serious, non-healing wound, ulcer, or bone fracture

- Proteinuria at screening as demonstrated by either: urine protein:creatinine (UPC)
ratio >= 1.0 at screening OR urine dipstick for proteinuria >= 2+ (patients
discovered to have >= 2+ proteinuria on dipstick urinalysis at baseline should
undergo a 24 hour urine collection and must demonstrate =< 1g of protein in 24 hours
to be eligible)

- Known hypersensitivity to any component of bevacizumab