Bevacizumab With or Without Sunitinib in Sunitinib-Refractory Renal Cell Carcinoma

Inclusion Criteria:

* Histologically confirmed metastatic renal cell carcinoma with clear cell histology
* Patients must be off sunitinib for 14 days prior to day 1 of treatment on protocol
* Evidence of unidimensionally measurable disease based on RECIST criteria, with at least 1 measurable lesion
* Radiographic evidence of disease progression defined by RECIST during or within 6 weeks of completion of sunitinib treatment
* Participants must have received at least 14 doses of sunitinib therapy
* Participants must enroll within 3 months of the last dose of sunitinib
* Males or females, age of 18 years or older
* ECOG Performance status 0-2
* Resolution of all acute toxic effects of prior therapy, radiotherapy or surgical procedures to NCI CTCAE version 3.0 grade 1 or less
* Laboratory values as defined in protocol
* 4 weeks or more must have elapsed from the time of major surgery and subjects must have recovered from the procedure prior to day 1 of randomization
* No anticipated need for major surgical procedure during the course of the study
* 2 weeks or more must have elapsed from the time of minor surgery and subjects must have recovered from the procedure prior to day 1 of randomization
* 4 weeks of more must have elapsed from the time of major radiotherapy prior to day 1 of randomization

Exclusion Criteria:

* Prior treatment with bevacizumab
* Unacceptable toxicity on prior sunitinib therapy at 37.5mg or lower
* Prior systemic therapy for RCC with \> 2 regimens
* Systemic therapy other than sunitinib within 4 weeks of starting the study treatment
* Uncontrolled high blood pressure
* Any prior history of hypertensive crisis or hypertensive encephalopathy
* History of abdominal fistula, gastrointestinal perforation or intraabdominal abscess within 3 months prior to day 0
* Any of the following within the 6 months prior to sudy drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, cerebrovascular accident or transient ischemic attack, symptomatic congestive heart failure, or ejection fraction \< 30%
* Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range without medication
* History of or known brain metastases or spinal cord compression
* NCI CTCAE grade 2 or above hemorrhage within 4 weeks of starting study treatment
* Significant vascular disease (e.g., aortic aneurysm, aortic dissection)
* Symptomatic peripheral vascular disease
* Grade 3 or higher cardiac dysrhythmia or QT prolongation
* Concurrent use of proarrhythmic medications including terfenadine, quinidine, procainamide, disopyramide, sotalol, probucol, bepridil, haloperidol, risperidone, indapamide and flecainide
* Pregnancy or breastfeeding or inadequate contraception
* Significant thromboembolic event within 6 months
* Evidence of bleeding diathesis or coagulopathy
* Serious, non-healing wound, ulcer or bone fracture
* Proteinuria at screening
* Known hypersensitivity to any component of bevacizumab
* Psychiatric illness/social situation that would limit compliance with study requirements
* Previous or concurrent malignancy requiring active systemic therapy