A Phase II Study of Ramucirumab With Somatostatin Analog Therapy in Patients With Advanced, Progressive Carcinoid Tumors

Inclusion Criteria: * Participants must have histologically or cytologically confirmed low- to intermediate-grade neuroendocrine tumor (carcinoid tumor). * Carcinoid tumors of any site are eligible. Patients with pancreatic neuroendocrine tumors are excluded. * Participants must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as ≥20 mm with conventional techniques or as ≥10 mm with spiral CT scan, MRI, or calipers by clinical exam. See Section 10 for the evaluation of measurable disease. * Locally advanced, unresectable or metastatic disease. * Patients must have evidence of radiographic disease progression within the past 12 months. Progressive disease by RECIST criteria is not required. * Age ≥ 18 years. * ECOG performance status 0-1 (see Appendix A). * Participants must have normal organ and marrow function as defined below: * absolute neutrophil count ≥1,000/ mm3 * platelets ≥100,000/ mm3 * hemoglobin ≥ 9 g/dL * total bilirubin ≤ 1.5 × institutional upper limit of normal * AST(SGOT)/ALT(SGPT) ≤ 3 × institutional upper limit of normal, or ≤ 5× institutional upper limit of normal in the setting of liver metastases * creatinine ≤ 1.5 × upper limit of normal * urinary protein ≤ 1+ on dipstick or routine urinalysis (if urine dipstick or routine urinalysis is 2+, a 24-hour urine collection for protein must dem…