Sorafenib + Topotecan for Platinum-Resistant Recurrent Ovarian Cancer

Inclusion Criteria:

Have histologically-confirmed epithelial ovarian cancer, primary peritoneal carcinomatosis or fallopian tube cancer. Enrollment of patients with clear cell histology is encouraged.
Have measurable disease according to RECIST or detectable disease by 1) CA-125 at least twice the ULN within 14 days prior to registration for protocol therapy; 2) Ascites and/or pleural effusion attributed to tumor; 3) solid and/or cystic abnormalities on radiographic imaging that do not meet RECIST definitions for target lesions.
Have failed at least one prior platinum based chemotherapeutic regimen.
No more than 3 prior treatment regimens for epithelial ovarian cancer.
Prior radiation therapy is allowed to < 25% of the bone marrow.
Be at least 4 weeks since last anti-cancer treatment, radiation or surgery at the time of registration for protocol therapy.
No active cancer in addition to the epithelial ovarian cancer within the last 5 years, with the exception of: superficial skin cancer (basal cell or squamous cell skin carcinoma; carcinoma in situ of the cervix; Stage I endometrial cancer with less than 50% invasion of the myometrium, or other adequately treated Stage I or II cancer in complete remission.
Age > 18 years at the time of consent
Written informed consent and HIPAA authorization for release of personal health information.
Females of childbearing potential must be willing to use an effective method of contraception (hormonal or barrier method of birth control; abstinence) from the time consent is signed until 90 days after treatment discontinuation
Females of childbearing potential must have a negative pregnancy test within 7 days prior to being registered for protocol therapy.

Exclusion Criteria:

No known or suspected allergy to sorafenib or any agent given in the course of this trial.
No prior treatment with anti-angiogenesis therapy.
No active CNS metastases.
No treatment with any investigational agent within 30 days prior to being registered for protocol therapy.
No concurrent combination anti-retroviral therapy for the treatment of immunodeficiency.
No clinically significant infections requiring antibiotic treatment.
No evidence of bowel obstruction, malabsorption, or other contraindication to oral medication.
No serious non-healing wound, ulcer, or bone fracture.
No major surgery, open biopsy or significant traumatic injury within 28 days of registration for protocol therapy.
No use of St. John's Wort or rifampin (rifampicin) while on protocol therapy.
No condition that impairs patient's ability to swallow whole pills.