Gemcitabine, Oxaliplatin in Combination With Bevacizumab in Biliary Tract and Gallbladder Cancer

Inclusion Criteria: * Histologically confirmed, locally unresectable or metastatic biliary tract or gallbladder adenocarcinoma. Patients must have at least one measurable lesion outside prior radiation field. * Zero to one prior chemotherapy for biliary tract or gallbladder cancer * Age \> 18 years * ECOG performance status 0-2 * Life expectancy \> 12 weeks * Adequate organ and bone marrow function Exclusion Criteria: * Chemotherapy within past 3 weeks of initiation of therapy * Pregnant or lactating women * Clinically apparent central nervous system metastases or carcinomatous meningitis * Biliary obstruction with inadequate drainage and total bilirubin \> 2.5 mg/dL * Concurrent malignancy of any site, except limited basal cell carcinoma or squamous cell carcinoma of the skin or carcinoma in situ of the cervix * Uncontrolled serious medical or psychiatric illness * Pre-existing peripheral neuropathy of grade 2 or greater severity according to the Common Terminology Criteria of the NCI (version 3.0) * Current, recent (within 4 weeks of the first infusion of this study), or planned participation in an experimental drug study * Blood pressure of \> 150/100 mmHg * Unstable angina * NYHA Grade II or greater congestive heart failure * History of myocardial infarction or stroke within 6 months * Clinically significant peripheral vascular disease * Evidence of bleeding diathesis or coagulopathy * Major surgical procedure, open biopsy, or significant traumatic injury with 28 days prior to Day 1, anticipation of need for major surgical procedure during the course of the study * History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to day 1 * Serious, non-healing wound, ulcer, or bone fracture