Dose Escalation of Bevacizumab With Ambulatory Blood Pressure Monitoring in Patients With Advanced Non-squamous NSCLC

Inclusion Criteria:

* Patients must have histologically or cytologically confirmed, newly diagnosed Stage IIIB, stage IV, or recurrent non-squamous NSCLC for which they have not received chemotherapy.
* Patients must have completed radiation therapy 2 weeks prior to enrollment. Patients may have received adjuvant therapy, provided the regimen included no more than one of the study agents.
* Patients must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension.
* Age \>18 years. •Life expectancy of greater than 4 months.
* ECOG performance status of 0 or 1
* Patients must have normal organ and marrow function
* Patients on anticoagulation are allowed.
* Women of child-bearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation.
* Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

Disease-Specific

* Patients who have had received prior chemotherapy (in the setting of recurrent disease, other than their original adjuvant therapy)
* Patients may not be receiving any other investigational agents.
* Patients with histologic evidence of predominantly squamous lung cell cancer

  * General Medical Exclusions
* Inability to comply with study and/or follow-up procedures
* Malignancy other than superficial basal cell and superficial squamous of the skin or carcinoma in situ of the cervix within last five years

Bevacizumab-Specific Exclusions

* Inadequately controlled hypertension
* Prior history of hypertensive crisis or hypertensive encephalopathy
* New York Heart Association Grade II or greater congestive heart failure
* History of myocardial infarction or unstable angina within 6 months prior to Day 1
* History of stroke or transient ischemic attack within 6 months prior to Day 1
* Known CNS disease, except for treated brain metastasis.
* Significant vascular disease within 6 months prior to Day 1
* History of hemoptysis within 1 month prior to Day 1
* Evidence of bleeding diathesis or significant coagulopathy
* Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 1 or anticipation of need for major surgical procedure during the course of the study
* Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to Day 1
* History of diverticulitis, abdominal fistula or gastrointestinal perforation within 6 months prior to Day 1
* Serious, non-healing wound, active ulcer, or untreated bone fracture
* Proteinuria as demonstrated by a UPC ratio 1.0 at screening
* Known hypersensitivity to any component of bevacizumab
* Pregnancy (positive pregnancy test) or lactation.
* Mixed tumors will be categorized by the predominant cell type unless small cell elements are present.
* Uncontrolled intercurrent illness including, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements.
* Any unstable condition that in the opinion of the investigator is likely to interfere with collection of accurate blood pressure measurement data .
* HIV-positive patients on combination antiretroviral therapy.