Fulvestrant and Bevacizumab in Treating Patients With Metastatic Breast Cancer

DISEASE CHARACTERISTICS:

* Histologically or cytologically confirmed breast cancer

  * Metastatic disease
* Must have received an aromatase inhibitor (e.g., letrozole, anastrozole, or exemestane) in an adjuvant or metastatic setting
* If tumor is HER2 positive (3+ by immunohistochemistry or amplified by fluorescent in situ hybridization) the patient must have received ≥ 1 prior trastuzumab (Herceptin®)-containing regimen unless there is a contraindication to trastuzumab
* Measurable or nonmeasurable disease, including any of the following :

  * Bone metastasis
  * Pleural/pericardial effusion
  * Ascites
  * Inflammatory skin changes
* No microscopic residual disease only
* Enrolled on or refused enrollment on clinical trial NCCTG-N0392
* No evidence of active brain metastasis including leptomeningeal involvement

  * CNS metastasis controlled (i.e., at least 2 months of no symptoms or evidence of progression) by prior surgery and/or raditherapy are allowed
* Hormone receptor status:

  * Estrogen and/or progesterone receptor-positive tumor

PATIENT CHARACTERISTICS:

* Male or female
* Female patients must be post-menopausal based on any 1 of the following criteria:

  * Age ≥ 60 years
  * Age ≥ 45 years with last menstrual period ≥ 12 months prior to study entry
  * Estradiol and follicle-stimulating hormone levels in postmenopausal range
  * History of bilateral oophorectomy
* ECOG performance status 0-2
* Life expectancy \> 3 months
* Fertile patients must use effective contraception during and for 30 days after completion of study treatment
* WBC ≥ 3,000 mg/dL
* Hemoglobin \> 8 g/dL
* Absolute neutrophil count \> 1,000/mm³
* Platelet count ≥ 100,000/mm³
* Bilirubin ≤ 1.5 times upper limit of normal (ULN)
* Alkaline phosphatase ≤ 2.5 times ULN
* AST and ALT ≤ 2.5 times ULN
* Creatinine ≤ 1.5 times ULN
* Urine protein \< 1+ OR \< 1 g of protein by 24-hour urine collection

  * No nephrotic syndrome
* No uncontrolled hypertension (i.e., blood pressure \[BP\] \> 160/90 mm Hg on ≥ 2 occasions at least 5 minutes apart)

  * Patients who have recently started or adjusted antihypertensive medications are eligible provided BP is \< 140/90 mm Hg on any new regimen for ≥ 3 different observations in ≥ 14 days
* No clinically significant cardiac disease, including any of the following:

  * Congestive heart failure
  * Symptomatic coronary artery disease
  * Unstable angina
  * Cardiac arrhythmias not well controlled with medication
  * Myocardial infarction within the past 12 months
* No arterial or venous thrombosis within the past 12 months
* No hemoptysis or gastrointestinal hemorrhage within the past 6 months
* No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 4 weeks
* No significant traumatic injury within the past 4 weeks
* No active, unresolved infection
* No history of hypertensive crisis or hypertensive encephalopathy
* No history of bleeding diathesis or uncontrolled coagulopathy
* No history of cerebrovascular accident, hemorrhage, or stroke
* No allergy or hypersensitivity to drug product excipients, murine antibodies, or agents chemically similar to study drugs
* No other malignancy within the past 3 years except for basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
* No other serious medical condition that would preclude study therapy or compliance

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* Prior radiotherapy to a target lesion allowed provided there has been clear progression since radiotherapy was completed
* At least 4 weeks since prior radiotherapy

  * Single-dose radiation for palliation or to a nontarget lesion only allowed within the past 4 weeks
* No more than 1 prior chemotherapy regimen for metastatic disease
* No more than 2 prior endocrine (hormonal) therapy regimens in the neoadjuvant, adjuvant, or metastatic setting
* At least 4 weeks since prior major surgery or open biopsy
* At least 4 weeks since prior chemotherapy or immunologic therapy
* At least 2 weeks since prior and no concurrent use of any of the following agents:

  * Aspirin (daily low-dose \[81 mg\] aspirin allowed\])
  * Thrombolytic agents
  * Anticoagulants (low-dose anticoagulation therapy to maintain patency of a vascular access device is allowed)
* No concurrent treatment in another clinical study with investigational procedures or investigational therapies
* No other concurrent anticancer therapy, including chemotherapy, biologic agents, or radiotherapy
* No routine use of granulocyte colony-stimulating factors during course 1
* No concurrent oprelvekin