Inclusion Criteria:

- Histologically or cytologically confirmed diagnosis of SCLC.

- First recurrence of SCLC after therapy with one prior chemotherapy regimen at initial
diagnosis.

- Relapsed SCLC of any duration (both sensitive and resistant relapse).

- ECOG performance status of
- Adequate bone marrow reserve, hepatic, renal, and cardiovascular function.

- No prior therapy with bevacizumab or any other VEGF inhibitor or topotecan

Exclusion Criteria:

- Uncontrolled emesis, regardless of etiology.

- Active uncontrolled infection.

- GI conditions or drugs that could impact absorption of oral topotecan.

- Known hypersensitivity to any component of topotecan capsule or compounds chemically
related to topotecan.

- Uncontrolled hypertension with BP>150/100.

- Prior h/o hypertensive crisis or encephalopathy.

- NYHA Grade II or greater congestive heart failure.

- H/O myocardial infarction within 6 months.

- H/O stroke or TIA within 6 months.

- H/O thrombotic or hemorrhagic disorders.

- Clinically significant vascular disease (e.g., aortic aneurysm requiring surgical
repair or recent peripheral arterial thrombosis) within 6 months.

- Major surgical procedure, open biopsy, or significant traumatic injury within 28
days.

- Anticipation of need for major surgical procedure during the study.

- Minor surgical procedures within 7 days prior to treatment start (placement of
vascular access devices is permitted).

- H/O abdominal fistula, GI perforation, or intra-abdominal abscess within prior 6
months. Serious, non-healing wound, active ulcer, or untreated bone fracture. - H/O
hemoptysis within prior 1 month.

- Concurrent radiotherapy.

- H/O whole lung radiation within 90 days prior to start of treatment.

- Presence or h/o central nervous system or brain metastases.

- H/o another malignancy other than SCLC.

- Concurrent chemotherapy, immunotherapy, or investigational therapy for the treatment
of small cell lung cancer.