Docetaxel, Gemcitabine and Bevacizumab for Metastatic Breast Cancer

Inclusion Criteria: * Histologically- or cytologically- confirmed metastatic breast adenocarcinoma * No HER2 overexpression or gene amplification * At least one previous chemotherapy regimen for metastatic breast cancer * Age ≥18 years * Performance status (WHO) 0-2 * Life expectancy of at least 12 weeks * Measurable disease as defined by at least 1 bidimensionally measurable lesion ≥ 20 X 10 mm * Performance status (WHO) 0-2 * Adequate liver function (serum bilirubin \<1.5 times the upper normal limit, AST and ALT \<2.5 times the upper normal limit in the absence of demonstrable liver metastases, or \<5 times the upper normal limit in the presence of liver metastases), adequate renal function (serum creatinine \<1.5 times the upper normal limit) and bone marrow ≥ 1,500/mm3, PLT ≥ 100,000/mm3, Hgb ≥ 9 g/dL) function * Written informed consent Exclusion Criteria: * Pregnant or lactating women * Progressive brain metastases according to clinical or radiological criteria * Brain metastases without prior radiation therapy * Radiation therapy within the previous 4 weeks * Previous radiation therapy to the only measurable lesion * Proteinuria ≥ 500 mgr of protein daily * Uncontrolled hypertension * Documented hemorrhagic diathesis or coagulation disorder * Cardiovascular disease (class II-IV NYHA congestive heart failure, myocardial infarction within the previous 4 months, unstable angina, LVEF \< normal, ventricular arrhythmia, uncontrolled hypertension) * Thrombotic event within the previous 6 months * Concurrent use of aspirin \> 325 mgr daily, low molecular weight heparin in therapeutic dose, warfarin or acenocoumarol, non-steroid anti-inflammatory agents * Major surgical procedure within the previous 4 weeks * Presence of nonhealing wound or fracture * Peripheral neuropathy \> grade 2 according to the NCI CTCAE (version 3.0) * Any sustained chronic toxicity \> grade 2 according to the NCI CTCAE (version 3.0) * Uncontrolled infection * Any serious, uncontrolled comorbidity on the investigator's judgment * Other cancer within the previous 5 years, except non-melanoma skin cancer and in situ cervical cancer * Serious psychiatric illness