Computed Tomography Perfusion Imaging in Predicting Outcomes in Patients with Ovarian, Fallopian Tube, or Primary Peritoneal Cancer Receiving Bevacizumab and Paclitaxel

Inclusion Criteria

• REGISTRATION TO STEP 0
• Patient must have epithelial ovarian, fallopian tube, or primary peritoneal cancer; this includes high-grade serous ovarian cancer, endometroid, clear cell, mixed epithelial, undifferentiated carcinoma, transitional cell carcinoma histologies * Patients with carcinosarcoma, non-epithelial, low grade tumors, or tumors with low malignant potential are excluded
• Patient must have suspected platinum-resistant disease (disease progression =< 6 months of platinum therapy)
• Patient must be expected to undergo therapy with bevacizumab in combination with paclitaxel at recommended standard of care doses if suspected recurrence is confirmed with imaging
• Patient must be able and willing to provide written informed consent
• Patient must have a life expectancy of >= 3 months
• Patient must have adequate bone marrow, coagulation, renal, and hepatic function; estimated glomerular filtration rate (eGFR) calculation >= 60 mL/min/1.73 m^2 (within 28 days of screening CT submission)
• Patient must demonstrate an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
• Patient must not have undergone therapy with any VEGF monoclonal antibodies in the last twelve weeks; patient must not have received any small molecule anti-VEGF drug within the previous 4 weeks
• Patient must not have undergone major surgery or radiotherapy to the pelvis or abdomen within previous 4 weeks
• Patients must not have known contraindications to bevacizumab, including but not limited to abdominal fistula, gastrointestinal (GI) perforation, intra-abdominal abscess, thrombotic or hemorrhagic disorders, uncontrolled hypertension or active clinically significant cardiovascular disease, non-healing wound, ulcer, or bone fracture within previous 4 weeks
• Patient must not have untreated or symptomatic central nervous system (CNS) metastasis
• Patient must not have another active (within past 3 years) or concurrent malignancy; resected basal cell skin cancer is allowed within past 3 years
• Patient must not have contraindication to iodinated contrast
• REGISTRATION TO STEP 1
• Patient must be evaluable using RECIST 1.1 criteria
• Patient must have perfusion CT target lesion (e.g., >= 1 cm in both the long and short axis, at least one half of the tumor appears enhancing and solid on a contrast-enhanced scan or has an attenuation of >= 10 Hounsfield unit [HU] on the unenhanced CT scan) on a contrast-enhanced conventional CT
• Conventional chest abdomen and pelvis CT images demonstrating recurrent tumor must be submitted within 21 days from acquisition to the American College of Radiology (ACR) Core Lab
• Eligibility of a perfusion CT target lesion must be confirmed by the ACR Core Lab prior to study enrollment and the T0 perfusion CT scan