Inclusion Criteria:

- Histologically or cytologically confirmed, metastatic (stage IV) small cell lung
cancer

- One previous chemotherapy regimen metastatic SCLC

- Measurable disease, defined as at least 1 bidimensionally measurable lesion ≥ 20 X 10
mm

- Age ≥ 18 years

- Performance status (WHO) 0-2

- Life expectancy of at least 12 weeks

- Adequate bone marrow (ANC ≥ 1,500/mm3, PLT ≥ 100,000/mm3, Hgb ≥ 11 g/dL), liver
(Bilirubin ≤ 1.5 upper normal limit, SGOT/SGPT ≤ 2.5 upper normal limit in the
absence of liver metastases or ≤ 5 upper normal limit in the presence of liver
metastases), and renal function (Creatinine ≤ 1,5 upper normal limit)

- Patients must be able to understand the nature of this study and give written
informed consent

Exclusion Criteria:

- Second primary malignancy, except for non-melanoma skin cancer

- Pregnant or lactating women

- Any serious, uncontrolled comorbidity on the investigator's judgment

- Uncontrolled infection

- Any sustained chronic toxicity > grade 2 according to the NCI CTCAE (version 3.0)

- Brain metastases, except if radiated and asymptomatic

- Radiotherapy within the previous 4 weeks

- Previous radiotherapy to the only measurable lesion

- Proteinuria ≥ 500 mgr of protein daily

- Hemoptysis > 10 cc per event

- Clinically significant hematemesis

- Centrally located lesion or in contact with major vessels

- Pulmonary lesion with cavitation

- Documented hemorrhagic diathesis or coagulation disorder

- Cardiovascular disease (class II-IV NYHA congestive heart failure, myocardial
infarction within the previous 4 months, unstable angina, LVEF < normal, ventricular
arrhythmia, uncontrolled hypertension)

- Thrombotic event within the previous 6 months

- Concurrent use of aspirin > 325 mgr daily, low molecular weight heparin in
therapeutic dose, warfarin or acenocoumarol, non-steroid anti-inflammatory agents

- Concurrent treatment with other anti-cancer drug

- Major surgical procedure within the previous 4 weeks

- Serum Να+ < 120 mg/dL