Inclusion Criteria

DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed non-squamous non-small cell lung cancer
(NSCLC)

- Newly diagnosed or recurrent disease

- Meets 1 of the following staging criteria:

- Stage IIIB disease, meeting both of the following criteria:

- Proven malignant effusion or supraclavicular node involvement (i.e., N3
supraclavicular nodes)

- Not a candidate for curative multimodality treatment or surgery

- Stage IV disease

- Measurable disease, defined as ≥ 1 lesion (outside of irradiated areas) that can be
measured in ≥ 1 dimension as ≥ 10 mm by spiral or multi-slice CT scan or MRI

- Immediate chemotherapy not clinically mandatory in the judgement of the investigator

- No intrathoracic large, centrally located tumors and/or cavitary lesions invading or
abutting major blood vessels

- No evidence of clinically active interstitial lung disease

- Patients with chronic stable radiographic changes who are asymptomatic are
eligible

- No small cell lung cancer (SCLC), squamous NSCLC, or combined SCLC-NSCLC tumors

- No brain metastases

PATIENT CHARACTERISTICS:

- WHO performance status 0-1

- Hemoglobin ≥ 10 g/dL

- Absolute neutrophil count ≥ 1,500/mm³

- Thrombocyte count ≥ 100,000/mm³

- Bilirubin ≤ 1.5 times upper limit of normal (ULN)

- ALT ≤ 2.5 times ULN (5 times ULN if liver metastases present)

- Alkaline phosphatase ≤ 2.5 times ULN (5 times ULN if bone metastases present)

- Quick ≥ 70% OR INR ≤ 1.5

- Creatinine ≤ 2.0 times ULN

- Proteinuria ≤ 2+ by urine dipstick

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception during and for 12 months after
completion of study treatment

- Able to understand trial information given by the investigator and complete quality
of life questionnaire

- No pre-existing condition that would preclude swallowing and/or absorption of oral
medication

- No prior or concurrent malignancies, except for the following:

- Malignancy for which the minimum relapse-free interval is ≥ 5 years

- Nonmelanoma skin cancer or adequately treated carcinoma in situ of the cervix

- No other medical condition that would preclude study participation, including any of
the following:

- Unstable or uncompensated respiratory, cardiac, hepatic, or renal disease

- Active infection

- Uncontrolled diabetes mellitus

- Hypertension ≥ 150/100 mm Hg despite treatment

- Myocardial infarction within the past 3 months

- History of hemorrhagic disorders

- Non-healing wound, ulcer, or bone fracture

- No clinical history of coagulopathy or thrombosis

- No hemoptysis or hematemesis ≥ grade 2 (defined as bright red blood of ≥ 5 mL per
episode) within the past 6 months

- No known hypersensitivity to study drug(s) or to any other component of the study
drugs

- No significant traumatic injury within the past 28 days

- No serious underlying medical condition that would impair the ability of the patient
to participate in the trial or that would preclude use of study drugs

- No cerebrovascular accident or other CNS bleeding within the past 6 months

PRIOR CONCURRENT THERAPY:

- At least 4 weeks since prior radiotherapy and recovered

- No prior radiotherapy to lesion(s) selected for measurement

- No prior chemotherapy for advanced disease

- At least 6 months since prior neoadjuvant or adjuvant systemic chemotherapy for
NSCLC

- Prior intrapleural or intrapericardial local chemotherapy allowed

- No prior endothelial growth factor and/or vascular endothelial growth factor
(receptor)-targeted therapy for NSCLC

- More than 28 days since prior major surgical procedure or open biopsy

- More than 30 days since prior treatment in another clinical trial

- No concurrent anticoagulants (e.g., phenprocoumon, acenocoumarol, or full-dose
warfarin or heparin)

- No concurrent full-dose continuous use of non-steroid anti-inflammatory drugs
(NSAIDs)

- No concurrent aspirin or clopidogrel bisulfate

- Low-dose aspirin (≤ 325 mg daily) may be continued in patients at high risk for
arterial thromboembolic disease

- No other concurrent drugs contraindicated for use with the study drugs, according to
the Swissmedic-approved product information

- No other concurrent experimental drugs or anticancer therapy, including chemotherapy,
immunotherapy, or hormone therapy