Inclusion Criteria:

1. Patients must have histologically confirmed adenocarcinoma of the small bowel or
ampulla of Vater.

2. Prior adjuvant chemotherapy (including 5-FU, capecitabine, and oxaliplatin) for the
treatment of adenocarcinoma of the small bowel or ampulla of Vater is allowed if
completed >/= 52 weeks prior to first dose of study treatment.

3. Prior capecitabine or 5-FU administered as a radiosensitizing agent concurrently with
external beam radiotherapy is allowed.

4. Patients must have metastatic disease

5. A minimum of 4 weeks must have elapsed from completion of any prior chemotherapy or
radiotherapy or surgery and the start date of study therapy.

6. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 to 2.

7. Adequate organ function including: Absolute neutrophil count (ANC) >/= 1,500/ul;
platelets >/= 100,000/ul; total bilirubin (SGOT) and ALT (SGPT) < 3 x ULN; calculated creatinine clearance (CrCl) > 50 cc/min
(calculated using the Cockcroft and Gault formula). *In patients with known Gilbert's
syndrome direct bilirubin instead of total bilirubin.

8. Negative serum or urine pregnancy test in women with childbearing potential (defined
as not post-menopausal for 12 months or no previous surgical sterilization), within
one week prior to initiation of treatment.

9. Patients must sign an Informed Consent and Authorization indicating that they are
aware of the investigational nature of this study and the known risks involved.

10. The effects of the combination of CAPOX and bevacizumab on the developing fetus are
unknown. For this reason, women of childbearing potential and men must agree to use
adequate contraception (hormonal or barrier method of birth control) prior to study
entry, for the duration of study participation, and for six months following the
completion of therapy. Should a woman become pregnant while participating in this
study, she should inform her treating physician immediately.

11. (continued from # 8). Because there is an unknown but potential risk for adverse
events in nursing infants secondary to treatment of the mother with oxaliplatin or
capecitabine or bevacizumab, breast feeding must be discontinued.

Exclusion Criteria:

1. Patients who have received prior chemotherapy for their metastatic disease are
excluded. Chemotherapy if given as a radiation-sensitizer is allowed.

2. Patients may not be receiving any other investigational agents nor have received any
investigational drug 28 days prior to enrollment.

3. Known history of dihydropyrimidine (DPD) deficiency.

4. Peripheral neuropathy of grade 3 or greater by Common Terminology Criteria for
Adverse Events (CTCAE) 4.0.

5. Gastrointestinal tract disease resulting in an inability to take oral medication or a
requirement for IV alimentation.

6. Because of the interaction between coumadin and capecitabine, patients taking
therapeutic doses of coumarin-derivative anticoagulants are not eligible. Low-dose
Coumadin (e.g. 1 mg PO per day) in patients with in-dwelling venous access devices is
allowed but increased frequency of INR monitoring is recommended.

7. Prior treatment with bevacizumab or known hypersensitivity to any component of
bevacizumab.

8. Inadequately controlled hypertension (defined as systolic blood pressure >140 mmHg
and/or diastolic blood pressure > 90 mmHg).

9. Prior history of hypertensive crisis or hypertensive encephalopathy.

10. Evidence of bleeding diathesis or significant coagulopathy (in the absence of
therapeutic anticoagulation).

11. New York Heart Association (NYHA) Grade II or greater congestive heart failure.

12. History of myocardial infarction or unstable angina within 6 months prior to Day 1.

13. History of stroke or transient ischemic attack within 6 months prior to Day 1.

14. Significant vascular disease (e.g., aortic aneurysm, requiring surgical repair or
recent peripheral arterial thrombosis) within 6 months prior to Day 1.

15. History of hemoptysis (>/= 1/2 teaspoon of bright red blood per episode) within 1
month prior to Day 1.

16. History of abdominal fistula or gastrointestinal perforation which must have resolved
at least 6 months prior to Day 1.

17. 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.

18. Core biopsy or other minor surgical procedure excluding placement of a vascular
access device, within 7 days prior to Day 1.

19. Serious, non-healing wound, active ulcer, or untreated bone fracture.

20. Proteinuria at screening as demonstrated by either (1) urine protein:creatinine (UPC)
ratio of >/= 1.0 or (2) urine dipstick for proteinuria >/= 2+ (patients discovered to
have >/= 2+ proteinuria on dipstick urinalysis should undergo a 24 hour urine
collection and must demonstrate
21. Known CNS disease, except for treated brain metastasis. Treated brain metastases are
defined as having no evidence of progression or hemorrhage after treatment and no
ongoing requirement for dexamethasone, as ascertained by clinical examination and
brain imaging (MRI or CT) during the screening period. Anticonvulsants (stable dose)
are allowed. Treatment for brain metastases may include whole brain radiotherapy
(WBRT), radiosurgery (RS; Gamma Knife, LINAC, or equivalent) or a combination as
deemed appropriate by the treating physician.

22. (continued from # 21) Patients with CNS metastases treated by neurosurgical resection
or brain biopsy performed within 3 months prior to Day 1 will be excluded.

23. Current, recent (within 4 weeks of the first infusion of this study), or planned
participation in an experimental drug study other than this study.

24. Pregnancy (positive pregnancy test) or lactation.

25. Active malignancy, other than superficial basal cell and superficial squamous (skin)
cell, or carcinoma in situ of the cervix, within last five years.

26. Inability to comply with study and/or follow-up procedures.

27. Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, or psychiatric illness/social
situations that would limit adherence with study requirements.

28. Age <18 years. Because no dosing or adverse event data are currently available on the
use of CAPOX and bevacizumab in patients <18 years of age, children are excluded from
this study.