Neoadjuvant Chemotherapy IV Carboplatin With Weekly Paclitaxel \Bevacizumab for Primary Ovarian

Phase I study proposed to evaluate:

• Tolerability of IV regimen carboplatin, paclitaxel and bevacizumab in the neoadjuvant setting prior to surgery.
• Safety/Toxicity of IV regimen in this patient population
• Treatment is Carboplatin area under the concentration curve (AUC) 5, Bevacizumab 15mg/m2, and starting dose of paclitaxel of 60mg/m2 and will be escalated in intervals of 10mg/m2 to a maximum dose of 80mg/m2.
• Patients will receive cycles 1-3 of carboplatin, bevacizumab, and paclitaxel and then cycle 4 will be carboplatin and paclitaxel followed by surgical intervention within 6 weeks of cycle 4.
• Post surgical treatment per physician discretion

Inclusion criteria

• histology,cytologically diagnosed epithelial ovarian, primary peritoneal or fallopian tube cancer
• FIGO (International Federation of Gynecology and Obstetrics stage III or IV disease
• GOG (Gynecologic Oncology Group) Performance Status 0,1,2
• No prior surgery for their malignancy
• Adequate bone marrow function
• Platelet count greater than or equal to 100,000
• Renal Function: Creatinine < 1.5 institutional upper limit normal
• Hepatic Function: Bilirubin less than 1.5 ULN (upper limit of normal)
• Hepatic Function: SGOT (serum glutamate oxaloacetate transaminase) and Alkaline Phosphate
• Neurologic Function: Neuropathy less than CTCAE (Common Toxicity Criteria for Adverse Effects)grade 1
• Coagulation Functions: INR<1.5 and PTT ,1.2 times the upper limit of normal
• Measurable disease

Exclusion criteria

• Previous cancer related surgery
• Received prior chemotherapy, immunotherapy, radiotherapy, hormonal therapy or biologic therapy for their ovarian, fallopian tube or primary peritoneal cancer.
• Borderline ovarian tumors, recurrent epithelial ovarian or primary peritoneal cancer or non-epithelial ovarian are not eligible.
• Other cancers within 5 years (other than non-melanoma skin cancer)
• Acute Hepatitis or end stage liver disease
• History of prior gastrointestinal perforation
• Evidence of abdominal free air not explained by paracentesis
• Sign or symptoms of gastrointestinal obstruction
• Active bleeding or pathologic conditions that carry high risk of bleeding
• CNS (Central Nervous System) disease
• Clinically Significant cardiovascular disease
• Known hypersensitivity to Chinese Hamster ovary cell products or other recombinant human or humanized antibodies
• Clinically significant proteinuria.
• Hypertensive crises or hypertensive encephalopathy
• History of hemoptysis
• Any non-study related invasive procedure within 28 days fo first date of bevacizumab
• GOG performance status 3 or 4
• Patients who are pregnant or nursing.
• Under the age of 18
• Received prior treatment of bevacizumab or any anti-VEGF (vascular endothelial growth factor) drug