Pegylated Liposomal Doxorubicin Hydrochloride, Carboplatin, Veliparib, and Bevacizumab in Treating Patients With Recurrent Ovarian Cancer, Primary Peritoneal Cancer, or Fallopian Tube Cancer

Inclusion Criteria:

• Patients must have histologic diagnosis of epithelial ovarian, fallopian tube, orprimary peritoneal carcinoma which is now recurrent; histologic documentation of theoriginal primary tumor is required via the pathology report

• Patients with the following histologic epithelial cell types are eligible: high-gradeserous adenocarcinoma, endometrioid adenocarcinoma, undifferentiated carcinoma, clearcell adenocarcinoma, mixed epithelial carcinoma or adenocarcinoma not otherwisespecified (N.O.S.)

• Patients must have recurrence documented by elevated cancer antigen (CA)-125 (biochemical recurrence) or clinically evident measurable or non-measurable recurrentdisease

• Biochemical recurrence is defined as a CA-125 greater than or equal to two timesthe upper normal limit; patients whose CA-125 is less than 100 U/mL must undergoa second confirmatory value within a period of not more than 4 weeks; patientswith a level greater than or equal to 100 U/mL may be entered withoutconfirmatory measurement; the CA-125 assessment for eligibility must be done atleast 4 weeks after paracentesis or other surgical procedures

• Detectable (non-measurable) disease is defined as symptomatic ascites or pleuraleffusions, solid and/or cystic abnormalities on radiographic imaging that do notmeet Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 definitions fortarget lesions and/or biopsy proven recurrence

• Measurable disease will be defined by RECIST 1.1; measurable disease is definedas at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded); each lesion must be >= 10 mm when measured bycomputed tomography (CT), magnetic resonance imaging (MRI) or caliper measurementby clinical exam; or >= 20 mm when measured by chest x-ray; lymph nodes must be >= 15 mm in short axis when measured by CT or MRI

• Patients with measurable disease must have had at least one "target lesion" to beused to assess response on this protocol as defined by RECIST 1.1; tumors withina previously irradiated field will be designated as "non-target" lesions unlessprogression is documented or a biopsy is obtained to confirm persistence at least 90 days following completion of radiation therapy

• Absolute neutrophil count (ANC) greater than or equal to 1,500/mcl

• This ANC cannot have been induced or supported by granulocyte colony-stimulatingfactors

• Platelets greater than or equal to 100,000/mcl

• Creatinine =< 1.5 times institutional upper limit of normal (ULN)

• Bilirubin < 1.2 times ULN

• Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) andserum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) =< 3.0times ULN

• Alkaline phosphatase =< 2.5 times ULN

• Left ventricular ejection fraction (LVEF) greater than or equal to institutional lowerlimit of normal (LLN) as determined by gated cardiac radionucleotide scan (MUGA) orechocardiogram

• Neuropathy (sensory and motor) less than or equal to grade 1

• Patients must have a platinum-free interval following initial platinum-basedchemotherapy of at least 6 months at first recurrence; front-line therapy may haveincluded a biologic/targeted agent (e.g., bevacizumab)

• NOTE: Front-line treatment may have included maintenance therapy; patientsreceiving maintenance therapy (biological therapy, hormonal, or taxane therapy)are ELIGIBLE provided their platinum-free interval is at least 6 months frominitial chemotherapy AND a minimum of 4 weeks has elapsed since their last doseof biologic/targeted or taxane therapy or a minimum of 1 week has elapsed sincetheir last dose of hormonal therapy

• Patients must have a Gynecologic Oncology Group (GOG) performance status of 0 or 1

• Patients of childbearing potential must have a negative pregnancy test prior to thestudy entry and be practicing an effective form of contraception; if applicable,patients must discontinue breastfeeding prior to study entry

• Patients who have met the pre-entry requirements

• Patients must have signed an Institutional Review Board (IRB)-approved informedconsent and authorization permitting release of personal health information

• ADDITIONAL CRITERIA FOR PATIENTS BEING TREATED ON BEVACIZUMAB COHORT

• Prothrombin time (PT) such that international normalized ratio (INR) is =< 1.5 X ULN (or an in-range INR, usually between 2 and 3, if a patient is on a stable dose oftherapeutic warfarin) and a partial thromboplastin time (PTT) < 1.5 X ULN

• Urine protein should be screened by urine analysis; if protein is 2+ or higher, 24-hour urine protein should be obtained and the level should be < 1000 mg for patientenrollment

• Patients treating with enoxaparin are eligible for inclusion in the study

• Fertile women must agree to use adequate contraceptive measures during study therapyand for at least 6 months after the completion of bevacizumab therapy; should a womanbecome pregnant or suspect she is pregnant while she or her partner is participatingin this study, the patient should inform the treating physician immediately

Exclusion Criteria:

• Patients who have received more than one previous regimen of chemotherapy (maintenanceis not considered a second regimen)

• Patients who have received prior ABT-888 or any other poly-adenosine diphosphate (ADP)--ribose polymerase (PARP) inhibitor

• Patients who have received prior PLD

• History of allergic reactions attributed to compounds of similar chemical or biologiccomposition to ABT-888 or other agents used in this study

• Patients with other invasive malignancies, with the exception of non-melanoma skincancer and other specific malignancies are excluded if there is any evidence of othermalignancy being present within the last three years; patients are also excluded iftheir previous cancer treatment contraindicates this protocol therapy

• Patients who have received prior radiotherapy to any portion of the abdominal cavityor pelvis are excluded; prior radiation for localized cancer of the breast, head andneck, or skin is permitted, provided that it was completed more than three years priorto registration, and the patient remains free of recurrent or metastatic disease

• Patients who have received prior chemotherapy for any abdominal or pelvic tumor (otherthan ovarian, fallopian tube and primary peritoneal) are excluded; patients may havereceived prior adjuvant chemotherapy for localized breast cancer, provided that it wascompleted more than three years prior to registration, and that the patient remainsfree of recurrent or metastatic disease

• Patients with synchronous primary endometrial cancer or a history of endometrialcancer, unless all of the following conditions are met:

• Stage not greater than IB

• No more than superficial myometrial invasion

• No vascular or lymphatic invasion

• No poorly differentiated subtypes, including papillary serous, clear cell, orother International Federation of Gynecology and Obstetrics (FIGO) grade 3lesions

• Patients with known chronic or active hepatitis or ongoing or active infection thatrequires parenteral antibiotics

• Patients with concurrent severe medical problems unrelated to the malignancy thatwould significantly limit full compliance with the study or expose the patient toextreme risk or decreased life expectancy

• Patients of childbearing potential, not practicing adequate contraception, patientswho are pregnant or patients who are breastfeeding are not eligible for this trial

• Patients with seizures or a history of seizures are ineligible

• Patients with history or evidence upon physical examination of central nervous system (CNS) disease, including primary brain tumor, any CNS metastases, or history ofcerebrovascular accident (CVA, stroke), transient ischemic attack (TIA) orsubarachnoid hemorrhage within six months of the first date of treatment on thisstudy; patients with CNS metastases must be stable for > 3 months after treatment andoff steroid treatment prior to study enrollment

• Patients who cannot swallow pills

• ADDITIONAL CRITERIA FOR PATIENTS BEING TREATED ON BEVACIZUMAB COHORT:

• History of allergic reactions attributed to compounds of similar chemical or biologiccomposition to bevacizumab

• Pregnant women are excluded from this study; breastfeeding should be discontinued ifthe mother is treated with bevacizumab

• Human immunodeficiency virus (HIV)-positive patients on combination antiretroviraltherapy are ineligible

• Urine protein should be screened by urine analysis; if protein is 2 + or higher, 24-hour urine protein should be obtained and the level should be < 1000 mg for patientenrollment

• Serious non-healing wound, ulcer, or bone fracture

• History of abdominal fistula, gastrointestinal perforation or intra-abdominal abscesswithin 6 months to day 1

• Invasive procedures defined as follows:

• Major surgical procedure, open biopsy or significant traumatic injury within 28days prior to day 1 therapy

• Anticipation of need for major surgical procedures during the course of the study

• Core biopsy within 7 days prior to day 1 (D1) therapy

• Significant vascular disease (e.g., aortic aneurysm, requiring surgical repair orrecent peripheral arterial thrombosis) within 6 months prior to day 1

• Known CNS disease except for treated brain metastases; treated brain metastases aredefined as having no ongoing requirement for steroids and no evidence of progressionor hemorrhage after treatment for at least 3 months, as ascertained by clinicalexamination and brain imaging (magnetic resonance imaging [MRI] or computed tomography [CT]); (stable dose of anticonvulsants are allowed); treatment for brain metastasesmay include whole brain radiotherapy (WBRT), radiosurgery (RS; Gamma Knife, LINAC, orequivalent) or a combination as deemed appropriate by the treating physician; patientswith CNS metastases treated by neurosurgical resection or brain biopsy performedwithin 3 months prior to Day 1 will be excluded

• Patients with clinically significant cardiovascular disease are excluded

• Inadequately controlled hypertension (HTN) (systolic blood pressure [SBP] > 160mm Hg and/or diastolic blood pressure [DBP] > 90 mm Hg despite antihypertensivemedication)

• History of cerebrovascular accident (CVA) within 6 months

• History of myocardial infraction or unstable angina within 6 months

• New York Heart Association grade II or greater congestive heart failure

• Serious and inadequately controlled cardiac arrhythmia

• Significant vascular disease (e.g. aortic aneurysm, history of aortic dissection)

• Clinically significant peripheral vascular disease

• Evidence of bleeding diathesis or coagulopathy

• Patients with known hypersensitivity to Chinese hamster ovary cell products or otherrecombinant human antibodies