Carboplatin, Paclitaxel, and Bevacizumab in Treating Patients With Locally Recurrent or Metastatic Breast Cancer

DISEASE CHARACTERISTICS:

Histologically or cytologically confirmed primary adenocarcinoma of the breast

Locally recurrent or metastatic disease
Must have HER-2-negative breast cancer or, if HER-2-positive, must be unable to receive trastuzumab (Herceptin®) or have previously received trastuzumab in the past
Measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as > 20 mm by conventional techniques or as > 10 mm by spiral CT scan.
No known CNS disease
Hormone receptor status not specified

PATIENT CHARACTERISTICS:

Inclusion criteria:

Postmenopausal status not specified
ECOG performance status (PS) 0-1 OR Karnofsky PS 70-100%
Life expectancy > 12 weeks
WBC ≥ 3,000/mcL
Absolute neutrophil count ≥ 1,500/mcL
Platelet count ≥ 100,000/mcL
Total bilirubin normal
AST and ALT ≤ 2.5 times upper limit of normal (ULN)
Alkaline phosphatase ≤ 2.5 times ULN (unless bone metastasis is present in the absence of liver metastasis)
Creatinine ≤ 1.5 mg/dL
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No other concurrent malignancies within the past 5 years except basal cell or squamous cell skin cancer or carcinoma in situ of the cervix

Exclusion criteria:

Pre-existing neuropathy ≥ grade 1

Uncontrolled intercurrent illness including, but not limited to, any of the following:

Ongoing or active infection
Symptomatic congestive heart failure
Unstable angina pectoris
Cardiac arrhythmia
Serious, non-healing wound, ulcer, or bone fracture
Psychiatric illness/social situations that would limit compliance with study requirements
Inadequately controlled hypertension (defined as systolic blood pressure > 150 mm Hg and/or diastolic blood pressure > 100 mm Hg on antihypertensive medications)
History of hypertensive crisis or hypertensive encephalopathy
New York Heart Association class II-IV congestive heart failure
History of myocardial infarction or unstable angina within the past 6 months
History of stroke or transient ischemic attack within the past 6 months
Significant vascular disease (e.g., aortic aneurysm, aortic dissection)
Symptomatic peripheral vascular disease
Evidence of bleeding diathesis or coagulopathy
Significant traumatic injury within the past 28 days
History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months

Proteinuria, as demonstrated by either urine protein:creatinine ratio ≥ 1.0 OR urine dipstick for proteinuria ≥ 2+

Patients discovered to have ≥ 2+ proteinuria on dipstick urinalysis at baseline must demonstrate 24-hour urine protein ≤ 1g
History of allergy or hypersensitivity to paclitaxel albumin-stabilized nanoparticle formulation, paclitaxel, bevacizumab, carboplatin, albumin, drug product excipients, or chemically similar agents

PRIOR CONCURRENT THERAPY:

See Disease Characteristics
Recovered from all prior therapy
No prior chemotherapy for locally recurrent or metastatic disease
Prior neoadjuvant or adjuvant chemotherapy allowed
More than 1 week since prior core biopsy or other minor surgical procedure, excluding placement of a vascular access device
More than 4 weeks since prior and no concurrent major surgical procedure or open biopsy
More than 4 weeks since prior radiotherapy
More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C)
At least 1 year since prior taxane regimen
No other concurrent investigational agents

Concurrent anticoagulation allowed, provided the following criteria are met:

Stable dose of warfarin or low molecular weight heparin
INR within desired range (2-3)
No evidence of active bleeding or coagulopathy
No concurrent combination antiretroviral therapy for HIV-positive patients
No other concurrent radiotherapy, chemotherapy, immunotherapy, or antitumor hormonal therapy