Efficacy of Bevacizumab Monotherapy in Treatment of Metastatic Melanoma

LEVEL A (second line): after confirmed progression on standard first line treatment with dacarbazine. LEVEL B (first line): when objective clinical response is observed in LEVEL A, patients will be included for first line treatment with bevacizumab Inclusion Criteria: * Histologically confirmed metastatic (unresectable) melanoma and with progressive disease * WHO performance status 0-2 * Age \>18 years * Able to undergo outpatient treatment * Patients must have clinically and/or radiographically documented measurable disease according to RECIST criteria * At least 4 weeks since adjuvant interferon alpha * Recovered from prior chemotherapy * Major surgical procedure or significant traumatic injury within 28 days prior to study treatment start. Biopsy or fine needle aspiration within 5 days prior to study treatment start. Central venous line placement must be inserted at least 5 days prior to treatment start. * Minimum required laboratory data: Hematology: absolute granulocytes \> 1.0 x 109/L platelets \> 100 x 109/L Biochemistry: bilirubin \< 1.5 x upper normal limit serum creatinine within normal limits INR \< 1.5 * Before patient registration/randomization, written informed consent must be given according to national and local regulations. Exclusion Criteria: * No pregnant or lactating patients can be included * No prior interferon alpha or IL-2 for metastatic disease * No more than 1 prior chemotherapy regimen for metastatic disease * No clinical evidence of coagulopathy * No brain metastases * No symptomatic congestive heart failure * No unstable angina pectoris * No cardiac arrhythmia * No history of thrombosis * No full-dose oral coumarin-derived anticoagulants (INR\>1.5) or heparin, thrombolytic agents, or chronic, daily treatment with aspirin (\>325 mg/day) * No non-steroidal anti-inflammatory medications (those known to inhibit platelet function at doses used to treat chronic inflammatory diseases) * No uncontrolled hypertension * Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial