Gemcitabine, Oxaliplatin in Combination With Bevacizumab in Biliary Tract and Gallbladder Cancer

Inclusion Criteria: Histologically confirmed, locally unresectable or metastatic biliary tract or gallbladder adenocarcinoma. Patients must have at least one measurable lesion outside prior radiation field. Zero to one prior chemotherapy for biliary tract or gallbladder cancer Age > 18 years ECOG performance status 0-2 Life expectancy > 12 weeks Adequate organ and bone marrow function Exclusion Criteria: Chemotherapy within past 3 weeks of initiation of therapy Pregnant or lactating women Clinically apparent central nervous system metastases or carcinomatous meningitis Biliary obstruction with inadequate drainage and total bilirubin > 2.5 mg/dL Concurrent malignancy of any site, except limited basal cell carcinoma or squamous cell carcinoma of the skin or carcinoma in situ of the cervix Uncontrolled serious medical or psychiatric illness Pre-existing peripheral neuropathy of grade 2 or greater severity according to the Common Terminology Criteria of the NCI (version 3.0) Current, recent (within 4 weeks of the first infusion of this study), or planned participation in an experimental drug study Blood pressure of > 150/100 mmHg Unstable angina NYHA Grade II or greater congestive heart failure History of myocardial infarction or stroke within 6 months Clinically significant peripheral vascular disease Evidence of bleeding diathesis or coagulopathy Major surgical procedure, open biopsy, or significant traumatic injury with 28 days prior to Day 1, anticipation of need for major surgical procedure during the course of the study History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to day 1 Serious, non-healing wound, ulcer, or bone fracture