Bevacizumab, Sorafenib Tosylate, and Temsirolimus in Treating Patients With Metastatic Kidney Cancer
Clear Cell Renal Cell Carcinoma, Recurrent Renal Cell Carcinoma, Stage IV Renal Cell Cancer AJCC v7
About this trial
This is an interventional treatment trial for Clear Cell Renal Cell Carcinoma
Eligibility Criteria
Inclusion Criteria:
- Patients will be required to have the clear cell variant of renal cell carcinoma with less than 25% of any other histology (including, but not limited to, papillary or chromophobe or oncocytic); there must be histologic confirmation by treating center of either primary or metastatic lesion
- Patients will be required to have measurable metastatic disease that is not curable by standard radiation therapy or surgery; all sites must be assessed within 4 weeks prior to study entry
Previous nephrectomy is required with the following exceptions:
- Primary tumor =< 5 cm, or
- Extensive liver (> 30% of liver parenchymal) or multiple (> 5) bone metastases, making nephrectomy a clinically questionable procedure
- Unresectable primary tumor due to invasion into adjacent organs or encasing the aorta or vena cava
- No prior cytotoxic chemotherapy; a maximum of one prior regimen of either vaccine or cytokine-based immunotherapy disease is permitted
- No prior anti-angiogenic therapy including, but not limited to, SU11248, ZD6474 or VEGF Trap; no prior therapy with bevacizumab, mammalian target of rapamycin (mTOR) inhibitors (including, but not limited to, temsirolimus), or sorafenib will be allowed; thalidomide or interferon alpha (IFNalpha) are allowed either for adjuvant therapy or stage IV disease
- No immunotherapy within 4 weeks of randomization; toxicities from immunotherapy must have resolved and a minimum of two weeks must pass prior to enrollment
- Prior radiation therapy is permitted, but toxicities from radiation must have resolved and a minimum of 2 weeks must pass prior to randomization
- No history or clinical evidence of central nervous system (CNS) disease, including primary brain tumor, seizures not controlled with standard medical therapy, any brain metastasis, or history of stroke within the past 48 weeks
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Life expectancy of greater than 12 weeks
- Hemoglobin (Hgb) >= 9.0 g/dL (transfusions allowed prior to enrollment)
- White blood count (WBC) >= 3,000/mm^3
- Absolute granulocyte count (AGC) >= 1,200/mm^3
- Platelet count >= 100,000/mm^3
- Serum creatinine =< 1.5 x upper limit of normal (ULN) or serum creatinine clearance (CrCl) >= 55 ml/min
- Total bilirubin =< 1.5 x ULN
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 2.5 x ULN (or =< 5.0 x ULN in the presence of liver metastases)
- International normalized ratio (INR) =< 1.5
- Activated partial thromboplastin time (aPTT) within normal limits
- Fasting cholesterol < 350 mg/dL (9.0 mmol/L)
- Fasting triglycerides < 400 mg/dL (4.56 mmol/L)
- Patients must not have other current malignancies, other than basal cell skin cancer, squamous cell skin cancer, in situ cervical cancer, and ductal or lobular carcinoma in situ of the breast; patients with other malignancies are eligible if they have been continuously disease-free for >= 5 years prior to the time of randomization
- No history of allergic reactions attributed to Chinese hamster ovary cell products, other recombinant human antibodies, or compounds of similar chemical or biologic composition to sorafenib, temsirolimus or bevacizumab
- No history of bleeding diathesis or coagulopathy
- Any condition that impairs patient's ability to swallow pills will make patient ineligible
- No major surgical procedure, open biopsy or significant traumatic injury within 28 days prior to randomization
- No anticipated need for major surgery during the course of the study
- No current or recent (within 4 weeks of enrollment) use of full-dose of anticoagulants or thrombolytic agents (except as required to maintain patency of preexisting or permanent indwelling IV catheters, for those patients receiving warfarin, INR must be =< 1.5)
No clinically significant cardiovascular disease, defined as one of the following:
- Patients with uncontrolled hypertension (blood pressure > 150/100 mm/Hg at the time of enrollment); patients with hypertension and blood pressure =< 150/100 mm/Hg on stable antihypertensive regimen are eligible
- Myocardial infarction or unstable angina < 24 weeks prior to registration
- New York Heart Association grade II or greater congestive heart failure, serious cardiac arrhythmia requiring medication, unstable angina pectoris
- Grade II or greater peripheral vascular disease
- No serious, non-healing wound, ulcer, or bone fracture
No significant proteinuria at baseline; urine protein must be screened within 2 weeks prior to randomization by urine analysis for urine protein creatinine (UPC) ratio; if UPC ratio is > 0.5, 24-hour urine protein is to be obtained and the level must be < 1000 mg for patient enrollment
- NOTE: UPC ratio of spot urine is an estimation of the 24 urine protein excretion; a UPC ratio of 1 is roughly equivalent to a 24-hour urine protein of 1 gm
- No uncontrolled intercurrent illness including, but not limited to, ongoing or active infection requiring parenteral antibiotics on day 0 or psychiatric illness/social situations that would limit compliance with study requirements
Patients currently taking any of the following cytochrome P450 enzyme-inducing drugs are ineligible:
- Phenytoin
- Carbamazepine
- Phenobarbital
- Rifampin
- Pregnant and breastfeeding women are excluded from the study; breastfeeding should be discontinued while receiving therapy; patients must have pregnancy test within 7 days prior to patient randomization if woman is of child-bearing capacity
- Human immunodeficiency virus (HIV)-positive patients receiving combination anti-retroviral therapy are excluded from the study
Sites / Locations
- University of Alabama at Birmingham Cancer Center
- Providence Hospital
- Mayo Clinic in Arizona
- The University of Arizona Medical Center-University Campus
- Mercy Hospital Fort Smith
- NEA Baptist Memorial Hospital
- University of Arkansas for Medical Sciences
- Alta Bates Summit Medical Center-Herrick Campus
- Providence Saint Joseph Medical Center/Disney Family Cancer Center
- Mills-Peninsula Medical Center
- East Bay Radiation Oncology Center
- Eden Hospital Medical Center
- Valley Medical Oncology Consultants-Castro Valley
- Bay Area Breast Surgeons Inc
- Valley Medical Oncology Consultants-Fremont
- Glendale Memorial Hospital and Health Center
- Marin Cancer Care Inc
- Marin General Hospital
- UC San Diego Moores Cancer Center
- USC / Norris Comprehensive Cancer Center
- Contra Costa Regional Medical Center
- Fremont - Rideout Cancer Center
- El Camino Hospital
- Palo Alto Medical Foundation-Camino Division
- Sutter Cancer Research Consortium
- Highland General Hospital
- Alta Bates Summit Medical Center - Summit Campus
- Bay Area Tumor Institute
- Hematology and Oncology Associates-Oakland
- Tom K Lee Inc
- Saint Joseph Hospital - Orange
- Palo Alto Medical Foundation Health Care
- Valley Care Health System - Pleasanton
- Valley Medical Oncology Consultants
- University of California Davis Comprehensive Cancer Center
- University of California San Diego
- Veterans Administration-San Diego Medical Center
- California Pacific Medical Center-Pacific Campus
- Doctors Medical Center- JC Robinson Regional Cancer Center
- Gene Upshaw Memorial Tahoe Forest Cancer Center
- Sutter Solano Medical Center/Cancer Center
- The Medical Center of Aurora
- University of Colorado Hospital
- Boulder Community Hospital
- Penrose-Saint Francis Healthcare
- UCHealth Memorial Hospital Central
- Porter Adventist Hospital
- University of Colorado
- Presbyterian - Saint Lukes Medical Center - Health One
- SCL Health Saint Joseph Hospital
- Rose Medical Center
- Colorado Cancer Research Program NCORP
- The Shaw Regional Cancer Center
- Swedish Medical Center
- Poudre Valley Hospital
- Valley View Hospital Cancer Center
- Saint Mary's Hospital and Regional Medical Center
- North Colorado Medical Center
- Saint Anthony Hospital
- Sky Ridge Medical Center
- Longmont United Hospital
- McKee Medical Center
- Montrose Memorial Hospital
- Saint Mary Corwin Medical Center
- North Suburban Medical Center
- SCL Health Lutheran Medical Center
- Hartford Hospital
- Beebe Medical Center
- Christiana Care Health System-Christiana Hospital
- Boca Raton Regional Hospital
- Mayo Clinic in Florida
- UF Cancer Center at Orlando Health
- John B Amos Cancer Center
- Northeast Georgia Medical Center-Gainesville
- Medical Center of Central Georgia
- Kootenai Cancer Center
- Saint Anthony's Health
- Rush - Copley Medical Center
- MacNeal Hospital and Cancer Center
- Saint Joseph Medical Center
- Illinois CancerCare-Bloomington
- Graham Hospital Association
- Illinois CancerCare-Canton
- Illinois CancerCare-Carthage
- Memorial Hospital
- Hematology and Oncology Associates
- Northwestern University
- Jesse Brown Veterans Affairs Medical Center
- University of Illinois
- Presence Resurrection Medical Center
- University of Chicago Comprehensive Cancer Center
- Decatur Memorial Hospital
- Heartland Cancer Research NCORP
- Advocate Sherman Hospital
- AMITA Health Alexian Brothers Medical Center
- Eureka Hospital
- Illinois CancerCare-Eureka
- NorthShore University HealthSystem-Evanston Hospital
- Galesburg Cottage Hospital
- Illinois CancerCare-Cottage
- Illinois CancerCare-Galesburg
- Ingalls Memorial Hospital
- Illinois CancerCare-Havana
- Mason District Hospital
- Hematology Oncology Associates of Illinois-Highland Park
- Hopedale Medical Complex - Hospital
- Midwest Center for Hematology Oncology
- Joliet Oncology-Hematology Associates Limited
- Illinois CancerCare-Kewanee Clinic
- Kewanee Hospital
- AMITA Health Adventist Medical Center
- NorthShore Hematology Oncology-Libertyville
- Illinois CancerCare-Macomb
- Mcdonough District Hospital
- Garneau, Stewart C MD (UIA Investigator)
- Porubcin, Michael MD (UIA Investigator)
- Sharis, Christine M MD (UIA Investigator)
- Spector, David MD (UIA Investigator)
- Stoffel, Thomas J MD (UIA Investigator)
- Trinity Medical Center
- Holy Family Medical Center
- Illinois CancerCare-Monmouth
- Good Samaritan Regional Health Center
- AMG Oncology - Naperville
- DuPage Medical Group-Ogden
- Illinois Cancer Specialists-Niles
- Bromenn Regional Medical Center
- Community Cancer Center Foundation
- Illinois CancerCare-Community Cancer Center
- Illinois CancerCare-Ottawa Clinic
- Ottawa Regional Hospital and Healthcare Center
- Illinois CancerCare-Pekin
- OSF Saint Francis Radiation Oncology at Pekin Cancer Treatment Center
- Pekin Hospital
- Proctor Hospital
- Illinois CancerCare-Peoria
- Methodist Medical Center of Illinois
- OSF Saint Francis Medical Center
- Illinois CancerCare-Peru
- Illinois Valley Hospital
- Illinois CancerCare-Princeton
- Perry Memorial Hospital
- Swedish American Hospital
- SwedishAmerican Regional Cancer Center/ACT
- Hematology Oncology Associates of Illinois - Skokie
- Illinois CancerCare-Spring Valley
- Saint Margaret's Hospital
- Memorial Medical Center
- Carle Cancer Center
- Franciscan Saint Francis Health-Beech Grove
- Elkhart Clinic
- Michiana Hematology Oncology PC-Elkhart
- Elkhart General Hospital
- Fort Wayne Medical Oncology and Hematology Inc-Parkview
- Indiana University/Melvin and Bren Simon Cancer Center
- Richard L. Roudebush Veterans Affairs Medical Center
- Sidney and Lois Eskenazi Hospital
- Community Howard Regional Health
- IU Health La Porte Hospital
- Horizon Oncology Research LLC
- Franciscan Saint Anthony Health-Michigan City
- Michiana Hematology Oncology PC-Mishawaka
- Saint Joseph Regional Medical Center-Mishawaka
- Michiana Hematology Oncology PC-Plymouth
- Reid Health
- Memorial Hospital of South Bend
- Michiana Hematology Oncology PC-South Bend
- South Bend Clinic
- Northern Indiana Cancer Research Consortium
- Michiana Hematology Oncology PC-Westville
- McFarland Clinic PC - Ames
- Constantinou, Costas L MD (UIA Investigator)
- University of Iowa Healthcare Cancer Services Quad Cities
- Mercy Hospital
- Oncology Associates at Mercy Medical Center
- Genesis Medical Center - East Campus
- Genesis Medical Center - West Campus
- Mercy Capitol
- Iowa Methodist Medical Center
- Iowa-Wide Oncology Research Coalition NCORP
- Medical Oncology and Hematology Associates-Des Moines
- Medical Oncology and Hematology Associates-Laurel
- Mercy Medical Center - Des Moines
- Iowa Lutheran Hospital
- University of Iowa/Holden Comprehensive Cancer Center
- Mercy Medical Center - North Iowa
- Ottumwa Regional Health Center
- Siouxland Regional Cancer Center
- Mercy Medical Center-Sioux City
- Saint Luke's Regional Medical Center
- Hospital District Sixth of Harper County
- Cancer Center of Kansas - Chanute
- Cancer Center of Kansas - Dodge City
- Cancer Center of Kansas - El Dorado
- Cancer Center of Kansas - Fort Scott
- Cancer Center of Kansas-Independence
- Cancer Center of Kansas-Kingman
- Lawrence Memorial Hospital
- Southwest Medical Center
- Cancer Center of Kansas - Newton
- Menorah Medical Center
- Radiation Oncology Practice Corporation Southwest
- Saint Luke's South Hospital
- Cancer Center of Kansas - Parsons
- Cancer Center of Kansas - Pratt
- Cancer Center of Kansas - Salina
- Shawnee Mission Medical Center-KCCC
- Cotton O'Neil Cancer Center / Stormont Vail Health
- Saint Francis Hospital and Medical Center - Topeka
- Cancer Center of Kansas - Wellington
- Associates In Womens Health
- Cancer Center of Kansas-Wichita Medical Arts Tower
- Cancer Center of Kansas - Wichita
- Via Christi Regional Medical Center
- Wichita NCI Community Oncology Research Program
- Cancer Center of Kansas - Winfield
- Doctors Carrol, Sheth, Raghavan
- Baton Rouge General Medical Center
- Mary Bird Perkins Cancer Center
- Ochsner Health Center-Summa
- Louisiana State University Health Science Center
- University Medical Center New Orleans
- Ochsner Medical Center Jefferson
- Eastern Maine Medical Center
- Saint Mary's Regional Medical Center
- Greater Baltimore Medical Center
- Sinai Hospital of Baltimore
- Union Hospital of Cecil County
- Frederick Memorial Hospital
- Beth Israel Deaconess Medical Center
- Bixby Medical Center
- Hickman Cancer Center
- Michigan Cancer Research Consortium NCORP
- Saint Joseph Mercy Hospital
- Bronson Battle Creek
- Spectrum Health Big Rapids Hospital
- Beaumont Hospital-Dearborn
- Ascension Saint John Hospital
- Green Bay Oncology - Escanaba
- Genesys Hurley Cancer Institute
- Hurley Medical Center
- Genesys Regional Medical Center-West Flint Campus
- Cancer Research Consortium of West Michigan NCORP
- Mercy Health Saint Mary's
- Spectrum Health at Butterworth Campus
- Green Bay Oncology - Iron Mountain
- Allegiance Health
- Bronson Methodist Hospital
- West Michigan Cancer Center
- Borgess Medical Center
- Sparrow Hospital
- Saint Mary Mercy Hospital
- Mercy Memorial Hospital
- Toledo Clinic Cancer Centers-Monroe
- Mercy Health Partners-Hackley Campus
- Mercy Health Mercy Campus
- Lakeland Hospital Niles
- Saint Joseph Mercy Oakland
- Lake Huron Medical Center
- Saint Mary's of Michigan
- Lakeland Medical Center Saint Joseph
- Marie Yeager Cancer Center
- Oncology Care Associates PLLC
- Providence Hospital-Southfield Cancer Center
- Munson Medical Center
- Saint John Macomb-Oakland Hospital
- Metro Health Hospital
- Medini, Eitan MD (UIA Investigator)
- Fairview Ridges Hospital
- Mercy Hospital
- Essentia Health Cancer Center
- Essentia Health Saint Mary's Medical Center
- Miller-Dwan Hospital
- Fairview-Southdale Hospital
- Etzell, Paul S MD (UIA Investigator)
- Swenson, Wade II, MD (UIA Investigator)
- Unity Hospital
- Hutchinson Area Health Care
- Meeker County Memorial Hospital
- Minnesota Oncology Hematology PA-Maplewood
- Saint John's Hospital - Healtheast
- Abbott-Northwestern Hospital
- Virginia Piper Cancer Institute
- Hennepin County Medical Center
- North Memorial Medical Health Center
- Mayo Clinic
- Coborn Cancer Center at Saint Cloud Hospital
- Saint Cloud Hospital
- Metro Minnesota Community Oncology Research Consortium
- Park Nicollet Clinic - Saint Louis Park
- Regions Hospital
- Saint Joseph's Hospital - Healtheast
- United Hospital
- Saint Francis Regional Medical Center
- Ridgeview Medical Center
- Rice Memorial Hospital
- Minnesota Oncology Hematology PA-Woodbury
- Woodwinds Health Campus
- University of Mississippi Medical Center
- Singing River Hospital
- Southeast Missouri Hospital
- Saint Francis Medical Center
- Centerpoint Medical Center LLC
- Mercy Hospital Joplin
- Truman Medical Center
- Saint Luke's Hospital of Kansas City
- Radiation Oncology Practice Corporation South
- Saint Joseph Health Center
- North Kansas City Hospital
- Heartland Hematology and Oncology Associates Incorporated
- Research Medical Center
- Radiation Oncology Practice Corporation - North
- Saint Luke's East - Lee's Summit
- Liberty Radiation Oncology Center
- Heartland Regional Medical Center
- Saint Joseph Oncology Inc
- Saint Louis Cancer and Breast Institute-South City
- Saint Louis University Hospital
- Washington University School of Medicine
- Missouri Baptist Medical Center
- Center for Cancer Care and Research
- Mercy Hospital Saint Louis
- Saint Louis-Cape Girardeau CCOP
- Mercy Hospital Springfield
- CoxHealth South Hospital
- Billings Clinic Cancer Center
- Northern Rockies Radiation Oncology Center
- Saint Vincent Healthcare
- Montana Cancer Consortium NCORP
- Saint Vincent Frontier Cancer Center
- Bozeman Deaconess Hospital
- Saint James Community Hospital and Cancer Treatment Center
- Benefis Healthcare- Sletten Cancer Institute
- Berdeaux, Donald MD (UIA Investigator)
- Big Sky Oncology
- Great Falls Clinic
- Northern Montana Hospital
- Saint Peter's Community Hospital
- Glacier Oncology PLLC
- Kalispell Medical Oncology
- Kalispell Regional Medical Center
- Montana Cancer Specialists
- Saint Patrick Hospital - Community Hospital
- Community Medical Hospital
- Guardian Oncology and Center for Wellness
- CHI Health Saint Francis
- CHI Health Good Samaritan
- Great Plains Health Callahan Cancer Center
- University of Nebraska Medical Center
- University Medical Center of Southern Nevada
- Nevada Cancer Research Foundation CCOP
- Portsmouth Regional Hospital
- Cooper Hospital University Medical Center
- Veterans Adminstration New Jersey Health Care System
- Morristown Medical Center
- Virtua Memorial
- Rutgers New Jersey Medical School
- Overlook Hospital
- Inspira Medical Center Vineland
- Virtua Voorhees
- Montefiore Medical Center-Wakefield Campus
- Montefiore Medical Center - Moses Campus
- Kings County Hospital
- State University of New York Downstate Medical Center
- Roswell Park Cancer Institute
- Mary Imogene Bassett Hospital
- Hematology Oncology Associates of Central New York-East Syracuse
- Glens Falls Hospital
- Northwell Health NCORP
- North Shore University Hospital
- Orange Regional Medical Center
- Long Island Jewish Medical Center
- Columbia University/Herbert Irving Cancer Center
- University of Rochester
- Mission Hospital Inc-Memorial Campus
- Cone Health Cancer Center at Alamance Regional
- Novant Health Presbyterian Medical Center
- Southeastern Medical Oncology Center-Goldsboro
- Wayne Memorial Hospital
- Margaret R Pardee Memorial Hospital
- Vidant Oncology-Kinston
- FirstHealth of the Carolinas-Moore Regional Hospital
- Rutherford Hospital
- Southeast Clinical Oncology Research (SCOR) Consortium NCORP
- Wake Forest University Health Sciences
- Mid Dakota Clinic
- Saint Alexius Medical Center
- Sanford Bismarck Medical Center
- Cleveland Clinic Akron General
- Mary Rutan Hospital
- Toledo Clinic Cancer Centers-Bowling Green
- Mercy Medical Center
- Aultman Health Foundation
- Adena Regional Medical Center
- The Christ Hospital
- MetroHealth Medical Center
- North Coast Cancer Care-Clyde
- Riverside Methodist Hospital
- Columbus NCI Community Oncology Research Program
- Grant Medical Center
- Mount Carmel Health Center West
- Doctors Hospital
- Grandview Hospital
- Good Samaritan Hospital - Dayton
- Miami Valley Hospital
- Samaritan North Health Center
- Dayton NCI Community Oncology Research Program
- Veteran Affairs Medical Center
- Grady Memorial Hospital
- Hematology Oncology Center Incorporated
- Mercy Cancer Center-Elyria
- Blanchard Valley Hospital
- Atrium Medical Center-Middletown Regional Hospital
- Fremont Memorial Hospital
- Wayne Hospital
- Kettering Medical Center
- Fairfield Medical Center
- Saint Rita's Medical Center
- Lima Memorial Hospital
- Marietta Memorial Hospital
- Saint Luke's Hospital
- Toledo Clinic Cancer Centers-Maumee
- Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
- Knox Community Hospital
- Licking Memorial Hospital
- Fisher-Titus Medical Center
- Saint Charles Hospital
- Toledo Clinic Cancer Centers-Oregon
- Firelands Regional Medical Center
- North Coast Cancer Care
- Springfield Regional Medical Center
- ProMedica Flower Hospital
- Mercy Hospital of Tiffin
- The Toledo Hospital/Toledo Children's Hospital
- Saint Vincent Mercy Medical Center
- University of Toledo
- Toledo Community Hospital Oncology Program CCOP
- Mercy Saint Anne Hospital
- Toledo Clinic Cancer Centers-Toledo
- Upper Valley Medical Center
- Fulton County Health Center
- Saint Ann's Hospital
- Clinton Memorial Hospital
- Greene Memorial Hospital
- Genesis Healthcare System Cancer Care Center
- University of Oklahoma Health Sciences Center
- Natalie Warren Bryant Cancer Center at Saint Francis
- Bay Area Hospital
- Kaiser Permanente Northwest
- Lehigh Valley Hospital-Cedar Crest
- Saint Luke's University Hospital-Bethlehem Campus
- Bryn Mawr Hospital
- Geisinger Medical Center
- Geisinger Medical Center-Cancer Center Hazleton
- Lancaster General Hospital
- Central PA Hematology-Medical Oncology Associates PC
- Riddle Memorial Hospital
- Paoli Memorial Hospital
- University of Pennsylvania/Abramson Cancer Center
- Pennsylvania Hospital
- Thomas Jefferson University Hospital
- Fox Chase Cancer Center
- Einstein Medical Center Philadelphia
- University of Pittsburgh Cancer Institute (UPCI)
- Mercy Hospital
- Hematology and Oncology Associates of North East Pennsylvania
- Scranton Hematology Oncology
- Geisinger Medical Group
- Reading Hospital
- Geisinger Wyoming Valley/Henry Cancer Center
- Geisinger South Wilkes-Barre
- Lankenau Medical Center
- Memorial Hospital of Rhode Island
- AnMed Health Hospital
- Spartanburg Medical Center
- Rapid City Regional Hospital
- Sanford Cancer Center Oncology Clinic
- Avera Cancer Institute
- Avera McKennan Hospital and University Health Center
- Medical X-Ray Center
- Sanford USD Medical Center - Sioux Falls
- Vanderbilt-Ingram Cancer Center Cool Springs
- Jackson-Madison County General Hospital
- Tennessee Cancer Specialists-Dowell Springs
- Thompson Cancer Survival Center
- East Tennessee Baptist Hospital-Mercy Health Partners
- University of Tennessee - Knoxville
- University of Tennessee Health Science Center
- Vanderbilt University/Ingram Cancer Center
- The Don and Sybil Harrington Cancer Center
- Texas Oncology-Austin Midtown
- Texas Oncology - Central Austin Cancer Center
- Texas Oncology - South Austin Cancer Center
- Texas Oncology-Austin North
- Texas Oncology Seton Northwest
- The Center for Cancer and Blood Disorders-Burleson
- Texas Oncology-Cedar Park
- The Center for Cancer and Blood Disorders-Cleburne
- The Center for Cancer and Blood Disorders-Fort Worth
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
- Baylor Saint Luke's Medical Center
- Ben Taub General Hospital
- Michael E DeBakey VA Medical Center
- The Methodist Hospital System
- The Center for Cancer and Blood Disorders-Mineral Wells
- Texas Oncology-Seton Williamson
- Texas Oncology - Round Rock Cancer Center
- Texas Oncology- San Marcos
- The Center for Cancer and Blood Disorders-Weatherford
- Danville Regional Medical Center
- Fredericksburg Oncology Inc
- Sovah Health Martinsville
- Virginia Commonwealth University/Massey Cancer Center
- PeaceHealth Saint Joseph Medical Center
- Harrison HealthPartners Hematology and Oncology-Bremerton
- Kadlec Clinic Hematology and Oncology
- Skagit Valley Hospital
- Harrison HealthPartners Hematology and Oncology-Poulsbo
- Minor and James Medical PLLC
- Kaiser Permanente Washington
- Swedish Medical Center-First Hill
- University of Washington Medical Center
- Cancer Care Northwest - Spokane South
- Evergreen Hematology and Oncology PS
- Rockwood Clinic
- Wenatchee Valley Hospital and Clinics
- West Virginia University Charleston Division
- Fox Valley Hematology and Oncology SC-Appleton
- Marshfield Clinic-Chippewa Center
- HSHS Sacred Heart Hospital
- Marshfield Clinic Cancer Center at Sacred Heart
- Green Bay Oncology at Saint Vincent Hospital
- Saint Vincent Hospital Cancer Center Green Bay
- Green Bay Oncology Limited at Saint Mary's Hospital
- Saint Vincent Hospital Cancer Center at Saint Mary's
- UW Cancer Center Johnson Creek
- Gundersen Lutheran Medical Center
- UW Health Oncology-One South Park
- Dean Hematology and Oncology Clinic
- University of Wisconsin Hospital and Clinics
- Holy Family Memorial Hospital
- Bay Area Medical Center
- Marshfield Clinic
- Marshfield Medical Center
- Froedtert and the Medical College of Wisconsin
- Marshfield Clinic-Minocqua Center
- Green Bay Oncology - Oconto Falls
- Ascension Saint Mary's Hospital
- Marshfield Clinic-Rice Lake Center
- Saint Michael's Hospital
- Green Bay Oncology - Sturgeon Bay
- Marshfield Clinic-Wausau Center
- Diagnostic and Treatment Center
- Marshfield Clinic - Weston Center
- Aspirus UW Cancer Center
- Marshfield Clinic - Wisconsin Rapids Center
- Rocky Mountain Oncology
- Welch Cancer Center
- Instituto Nacional de Enfermedades Neoplasicas
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Active Comparator
Experimental
Experimental
Experimental
Arm A (bevacizumab)
Arm B (bevacizumab and temsirolimus)
Arm C (bevacizumab and sorafenib tosylate)
Arm D (sorafenib tosylate and temsirolimus)
Patients receive bevacizumab IV over 30-90 minutes on days 1 and 15.
Patients receive temsirolimus IV over 30 minutes on days 1, 8, 15, and 22 and bevacizumab as in Arm A.
Patients receive bevacizumab as in Arm A and sorafenib tosylate PO BID on days 1-5, 8-12, 15-19, and 22-26.
Patients receive sorafenib tosylate PO BID on days 1-28 and temsirolimus as in Arm B.