Inclusion Criteria:

- Biopsy proven metastatic carcinoma with the following light microscopic histologies:
adenocarcinoma, poorly differentiated carcinoma(must have immunoperoxidase stains to
rule out lymphoma, neuroendocrine carcinoma),or poorly differentiated squamous
carcinoma.

- ECOG performance status 0-1

- No previous treatment with any systemic therapy

- Adequate kidney, liver and bone marrow function

- Be able to understand the nature of the study and give written informed consent

Exclusion Criteria:

- The following specific syndromes:

- Neuroendocrine carcinoma

- Women with adenocarcinoma isolated to axillary lymph nodes

- Women with adenocarcinoma isolated to peritoneal involvement

- Carcinoma involving only one site with resectable tumors at that site

- Squamous carcinoma limited to cervical, supraclavicular, or inguinal lymph nodes

- Uncontrolled brain metastases and all patients with meningeal involvement

- Women pregnant or lactating

- Clinically significant cardiovascular disease

- History of myocardial infarction or stroke within 6 months

- Clinical history of hemoptysis or hematemesis

- Patients with PEG tubes or G-tubes

- Proteinuria

- History of bleeding diathesis or coagulopathy

Please note: There are additional inclusion/exclusion criteria. The study center will
determine if you meet all of the criteria. If you do not qualify for the trial, study
personnel will explain the reasons. If you do qualify, study personnel will explain the
trial in detail and answer any questions you may have. You can then decide if you wish to
participate.