FOLFOX With Bevacizumab in Metastatic or Unresectable Gastroesophageal and Gastric Cancer

Inclusion Criteria: * Histologically or cytologically documented recurrent, metastatic or unresectable gastroesophageal (Siewert type I, II, III) or gastric adenocarcinoma with measurable or assessable non-measurable disease (RECIST criteria). * If recurrent or metastatic disease is not histologically confirmed, then documentation by a second radiographic procedure (i.e., PET scan or MRI in addition to CT scan) is required. If the imaging procedure does not confirm recurrent or metastatic disease, biopsy confirmation is required * 12 months since completion of any prior neoadjuvant or adjuvant therapy (chemotherapy or radiotherapy) for potentially resectable gastroesophageal or gastric adenocarcinoma. * \>4 weeks since major surgery. * ECOG Performance Status: 0-1 * Life expectancy \>12 weeks * Laboratory parameters as follows: absolute neutrophil count ≥1,500/uL, platelet count ≥100,000/uL, hemoglobin ≥9 g,/dL, creatinine \<1.5 X ULN or estimated GFR \>30 ml's/min, urinalysis \<2+ protein, baseline proteinuria \<1000 mg/d or urine protein/creatinine ratio \<1, bilirubin \<2 X ULN, PT (INR) \<1.5 if patient not on anticoagulation, negative pregnancy test in women of childbearing age * Hypertension must be well controlled (\<160/90) * Paraffin block or slides must be available * Patients on full-dose anticoagulants must be on a stable dose of warfarin and have an in-range INR or be on a stable dose of low molecular weight heparin. Exclusion Criteria: * prior treatment for recurrent, metastatic, or unresectable gastroesophageal or gastric adenocarcinoma * other concurrent anticancer therapy * other malignancy within past three years except basal cell carcinoma of the skin, cervical carcinoma in situ, or nonmetastatic prostate cancer known central nervous system metastases or carcinomatous meningitis. * interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the lung. * \> grade 2 sensory peripheral neuropathy. * uncontrolled seizure disorder, active neurological disease, or known CNS disease. * significant cardiac disease, including the following: unstable angina, New York Heart Association class II-IV congestive heart failure, myocardial infarction within six months prior to study enrollment. * history of hypertensive crisis or hypertensive encephalopathy * abdominal fistula, gastrointestinal bleeding, or intra-abdominal abscess within the 6 months prior to study enrollment. * core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to study enrollment. * major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to study enrollment or anticipation of need for major surgical procedure during the course of the study. * recent arterial thrombotic events including stroke or TIA within 6 months prior to study enrollment. * serious or non-healing wound, ulcer or bone fracture. * active bleeding or pathological condition that carries a high risk of bleeding (e.g., tumor involving major vessels or known varices).