Study of Oral Topotecan With Bevacizumab for Recurrent Small Cell Lung Cancer

Inclusion Criteria:

* Histologically or cytologically confirmed diagnosis of SCLC.
* First recurrence of SCLC after therapy with one prior chemotherapy regimen at initial diagnosis.
* Relapsed SCLC of any duration (both sensitive and resistant relapse).
* ECOG performance status of \</= 2.
* Adequate bone marrow reserve, hepatic, renal, and cardiovascular function.
* No prior therapy with bevacizumab or any other VEGF inhibitor or topotecan

Exclusion Criteria:

* Uncontrolled emesis, regardless of etiology.
* Active uncontrolled infection.
* GI conditions or drugs that could impact absorption of oral topotecan.
* Known hypersensitivity to any component of topotecan capsule or compounds chemically related to topotecan.
* Uncontrolled hypertension with BP\>150/100.
* Prior h/o hypertensive crisis or encephalopathy.
* NYHA Grade II or greater congestive heart failure.
* H/O myocardial infarction within 6 months.
* H/O stroke or TIA within 6 months.
* H/O thrombotic or hemorrhagic disorders.
* Clinically significant vascular disease (e.g., aortic aneurysm requiring surgical repair or recent peripheral arterial thrombosis) within 6 months.
* Major surgical procedure, open biopsy, or significant traumatic injury within 28 days.
* Anticipation of need for major surgical procedure during the study.
* Minor surgical procedures within 7 days prior to treatment start (placement of vascular access devices is permitted).
* H/O abdominal fistula, GI perforation, or intra-abdominal abscess within prior 6 months. Serious, non-healing wound, active ulcer, or untreated bone fracture. - H/O hemoptysis within prior 1 month.
* Concurrent radiotherapy.
* H/O whole lung radiation within 90 days prior to start of treatment.
* Presence or h/o central nervous system or brain metastases.
* H/o another malignancy other than SCLC.
* Concurrent chemotherapy, immunotherapy, or investigational therapy for the treatment of small cell lung cancer.