Bevacizumab in Treating Patients With Persistent or Recurrent Cancer of the Cervix

Inclusion Criteria

• •Histologically confirmed persistent or recurrent squamous cell carcinoma (SCC) of the cervix
• •Patients must have received at least 1, but no more than 2, prior cytotoxic chemotherapy regimens for advanced, metastatic, or recurrent SCC of the cervix
• •* Chemotherapy administered as a radio-sensitizer does not count as 1 regimen
• •Documented disease progression
• •At least 1 unidimensionally measurable lesion\*
• •* At least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan
• •No tumor involving major blood vessels
• •No history or physical evidence of CNS disease, including primary or metastatic brain tumor
• •Ineligible for a higher priority Gynecological Oncology Group (GOG) protocol (if one exists), including any active GOG phase III protocol for the same patient population
• •Performance status - GOG 0-2 (if received 1 prior regimen)
• •Performance status - GOG 0-1 (if received 2 prior regimens)
• •Absolute neutrophil count ≥ 1,500/mm\^3
• •Platelet count ≥ 100,000/mm\^3
• •No known bleeding disorder or coagulopathy
• •No other active bleeding or pathologic condition that would confer a high risk of bleeding
• •Bilirubin ≤ 1.5 times upper limit of normal (ULN)
• •SGOT ≤ 2.5 times ULN
• •Alkaline phosphatase ≤ 2.5 times ULN
• •INR ≤ 1.5 (or 2-3 for patients on a stable dose of therapeutic warfarin or low molecular weight heparin)
• •PTT \< 1.2 times control
• •Creatinine ≤ 1.5 times ULN
• •Creatinine clearance \> 60 mL/min
• •No proteinuria
• •* Urine protein \< 1+ on dipstick or \< 30 mg/dL
• •* Urine protein \< 1000 mg by 24-hour urine collection
• •No clinically significant cardiovascular disease
• •No uncontrolled hypertension
• •No myocardial infarction or unstable angina within the past 6 months
• •No New York Heart Association grade II-IV congestive heart failure
• •No serious cardiac arrhythmia requiring medication
• •No grade II or greater peripheral vascular disease
• •No history of stroke within the past 5 years
• •No greater than grade 1 sensory or motor neuropathy
• •No active infection requiring parenteral antibiotics
• •No serious nonhealing wound, ulcer, or bone fracture
• •No history or physical evidence of seizures not controlled with standard medical therapy
• •No known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies
• •No other invasive malignancy within the past 5 years except nonmelanomatous skin cancer
• •No significant traumatic injury within the past 4 weeks
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception during and for at least 3 months after completion of study treatment
• •No prior bevacizumab
• •At least 3 weeks since prior immunologic agents for SCC of the cervix
• •See Disease Characteristics
• •Recovered from prior chemotherapy
• •No prior non-cytotoxic chemotherapy for persistent or recurrent disease
• •At least 1 week since prior hormonal therapy for SCC of the cervix
• •Concurrent hormone replacement therapy allowed
• •See Disease Characteristics
• •Recovered from prior radiotherapy
• •Recovered from recent prior surgery
• •At least 4 weeks since prior major surgical procedure or open biopsy
• •At least 1 week since prior placement of vascular access device or core biopsy
• •No concurrent major surgical procedure
• •At least 3 weeks since other prior therapy for SCC of the cervix
• •No prior anticancer therapy that would preclude study therapy
• •No concurrent anticoagulants other than those required to maintain the patency of indwelling IV catheters
• •No concurrent chronic daily aspirin greater than 325 mg/day or other nonsteroidal anti-inflammatory medications that are known to inhibit platelet function at doses used for chronic inflammatory diseases