• To determine the objective response rate (CR + PR by RECIST) for the combination of paclitaxel, pemetrexed, and bevacizumab in patients with advanced NSCLC who have received no prior treatment for metastatic disease. [ Time Frame: conclusion of study ] [ Designated as safety issue: No ]
  

• Collecting patient-reported outcomes (toxicity-related symptoms) using wireless touchscreen laptop computers in the outpatient clinics via the MSKCC STAR system, with storage of this information in the institutional database, CRDB. [ Time Frame: conclusion of study ] [ Designated as safety issue: No ]
  
• Using an automated response assessment algorithm to determine unidimensional (RECIST) measurements of lesions. Measurements will be determined in real-time and response data will be automatically downloaded into the institutional database, CRDB. [ Time Frame: conclusion of study ] [ Designated as safety issue: No ]
  
• Collecting clinician-generated data using a web-based portal, StudyTracker, that automatically downloads information into the institutional data base, CRDB. [ Time Frame: conclusion of study ] [ Designated as safety issue: No ]
  
• To evaluate the safety and tolerability of the combination of paclitaxel, pemetrexed and bevacizumab given according to the dosing schedule outlined where both pemetrexed and bevacizumab are given biweekly. [ Time Frame: conclusion of the study ] [ Designated as safety issue: Yes ]
  
• To assess progression-free survival. [ Time Frame: conclusion of study ] [ Designated as safety issue: No ]
  
• To assess median, one- and two-year survival. [ Time Frame: conclusion of study ] [ Designated as safety issue: No ]
  
• To evaluate the extent to which clinicians will concur with patient self-reported CTCAE symptom and toxicity information. [ Time Frame: conclusion of study ] [ Designated as safety issue: No ]
  
• To correlate ERCC1 (excision repair cross-complementation group-1) tumor expression measured by immunohistochemistry with response to treatment. [ Time Frame: conclusion of study ] [ Designated as safety issue: No ]
  

Drug: Paclitaxel, pemetrexed and bevacizumab and Toxicity symptoms will be collected using the STAR system
During each 28-day cycle, paclitaxel will be given intravenously on days 1, 8 and 15 and pemetrexed and bevacizumab will be given intravenously on days 1 and 15. Paclitaxel will be administered at 90mg/m2 over 60 minutes on days 1, 8 and 15, Pemetrexed 500mg/m2 will be administered over 10 minutes on days 1 and 15. Bevacizumab will be given at 10mg/kg over 20 minutes on days 1 and 15 19, 52. This treatment regimen will be given for a total of six cycles, or until documentation of disease progression, unacceptable toxicity or patient refusal. After the completion of six cycles, patients will continue on bevacizumab every 2 weeks until progression of disease, unacceptable toxicity or patient refusal to further participate.

In this clinical trial, we also will be studying other things. We want to learn more about how to manage side effects patients may develop during chemotherapy. Cancer patients may develop side effects during treatment, such as nausea, pain, fatigue, diarrhea, constipation, or shortness of breath. These symptoms may be due to the cancer itself, or due to treatments like chemotherapy drugs or radiation therapy. Doctors and nurses often ask patients about their symptoms, because an important part of cancer treatment is to make patients feel as well as possible. If patients do not feel well, we may need to change the way we are treating them or prescribe therapies that will decrease their symptoms. The best way to find out how the patient is feeling is to ask them directly.

We are interested in developing new ways to ask patients about how they are feeling, using the Internet. A special new website called STAR ("Symptom Tracking and Reporting for Patients") has been developed to help patients record this information, so that their doctors and nurses can review it during clinic appointments. This study is designed to help us see if STAR is a helpful way for us to keep track of information about patients' symptoms and quality of life.

As part of this study, a computerized (automated) technique of determining the size of the patients tumor(s) before and after treatment will be used. This has been tested in the past and found to be more accurate. The automated technique of determining tumor size will be used with the routine CT scans that the patient will have as part of the study. This automated method of measuring the tumor(s) will allow us to know sooner whether this drug treatment is causing the disease to shrink.

The information from STAR and the automated tumor measurements are going to be placed on a very secure Internet site. This will provide the doctor with all of the information needed to determine if this drug combination is working for the patient and whether to continue this study.

Also, if there is a tumor sample from a biopsy done in the past, it will be analyzed for a protein that may be present in the lung cancer.