OBJECTIVES: A major challenge in the treatment of advanced non-small cell lung cancer (NSCLC) is balancing efficacy and tolerability.  We report findings from a prospective medical record (MR) registry that examined treatment effectiveness, toxicity, and patient reported outcomes in patients (pts) newly diagnosed with advanced NSCLC.  The focus of this report is progression free survival (PFS), overall survival (OS), and health-related quality of life (HRQOL) through one year of follow-up.  METHODS: Pts starting first line treatment of stage IIIB/IV nonsquamous NSCLC were prospectively enrolled and consented at 34 US-based community oncology settings.  Eligible pts received one of the following regimens: A: bevacizumab with platinum-based doublet, gemcitabine-based doublet, or pemetrexed and carboplatin; B: platinum or gemcitabine-based doublet without bevacizumab; C: pemetrexed with cisplatin or carboplatin.  From the MR, site staff collected baseline characteristics and treatment, toxicity, PFS and OS at 12 months.  HRQOL was assessed once per cycle during treatment with the EORTC QLQ-C30 and QLQ-LC13, the MDASI-LC, and the Rotterdam Activity Level Scale (RALS).  RESULTS: Of 155 eligible pts enrolled, 2 died before treatment start and 6 dropped out, leaving 147.  Of these, 66 (44.9%) received Regimen A, 25 (17.0%) Regimen B, and 56 (38.1%) Regimen C.   93 pts (63.3%) had at least one adverse event, with no difference in adverse event rate among regimens (p=0.1955).  Regimens did not differ on HRQOL outcomes.  Disease progression occurred in 141 pts (95.9%) and death in 102 (69.4%), based on scan records and physician progress notes.  Kaplan Meier median first-line PFS was A: 7.4 months, B: 4.2, C: 5.0 (p = 0.0013).  Median OS was A: 12.3 months, B: 5.9, C: 7.9 (p <0.0001).  CONCLUSIONS: Bevacizumab-containing regimens were associated with longer PFS and OS, with no significant difference in toxicities or HRQOL compared with other treatments.