Patients 18 years of age with stage IV nonsquamous NSCLC ( American Joint Committee on Cancer v7 .0 ) , and Eastern Cooperative Oncology Group performance status 0/1 were randomized ( 1:1 ) to four cycles of induction Pem + Cb ( pemetrexed , 500 mg/m , carboplatin , area under the curve = 6 ) followed by Pem maintenance or Pac + Cb + Bev ( paclitaxel , 200 mg/m , carboplatin , area under the curve = 6 , and bevacizumab , 15 mg/kg ) followed by Bev maintenance in the absence of progressive disease or discontinuation .