AMG 706 and Octreotide in Treating Patients With Low-Grade Neuroendocrine Tumors

DISEASE CHARACTERISTICS:

• Histologically confirmed low-grade neuroendocrine neoplasm
• Measurable disease

• Radiographic evidence of disease progression after any prior systemic therapy, chemoembolization, bland embolization, or observation, defined by either of the following:

  • Appearance of a new lesion
  • At least 20% increase in the longest diameter of any previously documented lesion or in the sum of the longest diameters of multiple lesions
• Tissue block from original diagnostic or surgical specimen required
• Concurrent stable-dose octreotide acetate required
• No small cell lung cancer, medullary thyroid cancer, paraganglioma, or pheochromocytoma

PATIENT CHARACTERISTICS:

• ECOG performance status 0-2
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• Must be able to receive a contrast-enhanced CT scan
• No known history of allergic reactions to AMG 706 or derivatives or to octreotide acetate injections
• No gastrointestinal tract disease resulting in an inability to take oral medication (i.e., ulcerative disease, uncontrolled nausea, vomiting, or diarrhea, bowel obstruction, or inability to swallow tablets)
• No requirement for IV alimentation
• Absolute neutrophil count ≥ 1,000/mm³
• Platelet count ≥ 75,000/mm³
• Hemoglobin level ≥ 8.0 g/dL
• Bilirubin ≤ 2.0 times upper limit of normal (ULN)
• AST ≤ 3 times ULN (5 times ULN if liver metastases are present)
• LVEF ≥ institutional lower limit of normal as evaluated by echocardiography or MUGA scan

• No history of uncontrolled hypertension (resting blood pressure > 150/90 mm Hg)

  • Antihypertensive medications allowed if patients is stable on their current dose

• No history of the following within the past 12 months:

  • New York Heart Association class III or IV congestive heart failure
  • Unstable angina pectoris
  • Myocardial infarction
  • Symptomatic cardiac arrhythmia
  • Cerebrovascular accident or transient ischemic attack
• No history of arterial or venous thrombosis within the past 12 months

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics

• One prior systemic chemotherapy regimen for low-grade neuroendocrine neoplasm allowed

  • Chemoembolization is not considered systemic chemotherapy
• At least 4 weeks since prior major surgery, chemotherapy, radiation therapy, other systemic therapy, or local liver therapy
• No prior procedures that would adversely affect intestinal absorption
• No prior anti-vascular endothelial growth factors
• No concurrent chemotherapy or radiation therapy