Bevacizumab With or Without Sunitinib in Sunitinib-Refractory Renal Cell Carcinoma

Inclusion Criteria: * Histologically confirmed metastatic renal cell carcinoma with clear cell histology * Patients must be off sunitinib for 14 days prior to day 1 of treatment on protocol * Evidence of unidimensionally measurable disease based on RECIST criteria, with at least 1 measurable lesion * Radiographic evidence of disease progression defined by RECIST during or within 6 weeks of completion of sunitinib treatment * Participants must have received at least 14 doses of sunitinib therapy * Participants must enroll within 3 months of the last dose of sunitinib * Males or females, age of 18 years or older * ECOG Performance status 0-2 * Resolution of all acute toxic effects of prior therapy, radiotherapy or surgical procedures to NCI CTCAE version 3.0 grade 1 or less * Laboratory values as defined in protocol * 4 weeks or more must have elapsed from the time of major surgery and subjects must have recovered from the procedure prior to day 1 of randomization * No anticipated need for major surgical procedure during the course of the study * 2 weeks or more must have elapsed from the time of minor surgery and subjects must have recovered from the procedure prior to day 1 of randomization * 4 weeks of more must have elapsed from the time of major radiotherapy prior to day 1 of randomization Exclusion Criteria: * Prior treatment with bevacizumab * Unacceptable toxicity on prior sunitinib therapy at 37.5mg or lower * Prior systemic therapy for RCC with \> 2 regimens * Systemic therapy other than sunitinib within 4 weeks of starting the study treatment * Uncontrolled high blood pressure * Any prior history of hypertensive crisis or hypertensive encephalopathy * History of abdominal fistula, gastrointestinal perforation or intraabdominal abscess within 3 months prior to day 0 * Any of the following within the 6 months prior to sudy drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, cerebrovascular accident or transient ischemic attack, symptomatic congestive heart failure, or ejection fraction \< 30% * Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range without medication * History of or known brain metastases or spinal cord compression * NCI CTCAE grade 2 or above hemorrhage within 4 weeks of starting study treatment * Significant vascular disease (e.g., aortic aneurysm, aortic dissection) * Symptomatic peripheral vascular disease * Grade 3 or higher cardiac dysrhythmia or QT prolongation * Concurrent use of proarrhythmic medications including terfenadine, quinidine, procainamide, disopyramide, sotalol, probucol, bepridil, haloperidol, risperidone, indapamide and flecainide * Pregnancy or breastfeeding or inadequate contraception * Significant thromboembolic event within 6 months * Evidence of bleeding diathesis or coagulopathy * Serious, non-healing wound, ulcer or bone fracture * Proteinuria at screening * Known hypersensitivity to any component of bevacizumab * Psychiatric illness/social situation that would limit compliance with study requirements * Previous or concurrent malignancy requiring active systemic therapy