Bevacizumab and PEG-Interferon Alfa-2b in Treating Patients With Metastatic or Unresectable Carcinoid Tumors

Inclusion Criteria:

* Histologically confirmed carcinoid tumor

  * Metastatic or unresectable local-regional disease
* Measurable disease
* No osseous metastasis as the only site of disease
* No history or clinical evidence of CNS disease (e.g., primary brain tumor or any brain metastasis)
* Performance status - Zubrod 0-2
* Performance status - Karnofsky 70-100%
* At least 12 weeks
* See Immunologic
* Absolute granulocyte count \> 1,500/mm\^3
* Platelet count \> 100,000/mm\^3
* Hemoglobin \> 8 g/dL
* No bleeding diathesis or coagulopathy
* No hemoglobinopathies (e.g., thalassemia) or any other cause of hemolytic anemia
* Bilirubin \< 1.5 mg/dL
* INR \< 1.5 (if receiving warfarin)
* No evidence of decompensated liver disease (e.g., ascites, bleeding varices, or spontaneous encephalopathy)
* Creatinine \< 1.5 mg/dL
* No baseline proteinuria

  * Patients with proteinuria (≥ 2+ or ≥ 100 mg/dL on urinalysis) are allowed provided 24-hour urinary protein is \< 500 mg
* No New York Heart Association grade II-IV congestive heart failure
* No serious cardiac arrhythmia requiring medication
* No clinically significant peripheral vascular disease
* No history of stroke
* None of the following within the past 6 months:

  * Uncontrolled hypertension
  * Transient ischemic attack
  * Cerebrovascular accident
  * Unstable angina
  * Myocardial infarction
* No chronic pulmonary disease (e.g., chronic obstructive pulmonary disease)
* No documented pulmonary hypertension
* None of the following immunologically mediated diseases:

  * Inflammatory bowel disease (e.g., Crohn's disease or ulcerative colitis)
  * Rheumatoid arthritis
  * Idiopathic thrombocytopenia purpura
  * Systemic lupus erythematosus
  * Autoimmune hemolytic anemia
  * Scleroderma
  * Severe psoriasis
* No serious concurrent infections
* No active infection requiring parental antibiotics on day 0
* No known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies
* No known hypersensitivity to interferon alfa or to any excipient or vehicle included in its formulation or delivery system
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No significant traumatic injury within the past 4 weeks
* No preexisting thyroid abnormality for which thyroid function can not be normalized by medication
* No concurrent nonmalignant uncontrolled medical illness or one whose control may be jeopardized by the complications of this study therapy
* No uncontrolled psychiatric disorder
* No psychiatric disorders that would preclude study compliance
* No other malignancy within the past 5 years except nonmelanoma skin cancer or carcinoma in situ of the cervix
* No serious nonhealing wound ulcer or bone fracture
* No seizures not controlled with standard medical therapy
* Prior immunotherapy allowed

  * No prior interferon
* No concurrent immunotherapy
* At least 4 weeks since prior chemotherapy, including radiosensitizers
* No more than 1 prior chemotherapy regimen, including radiosensitizers
* No concurrent chemotherapy
* At least 4 weeks since prior radiotherapy

  * Prior radiotherapy must not have contained the single evaluable lesion of this study in a radiation field
* No concurrent radiotherapy
* At least 4 weeks since prior major surgery or open biopsy (1 week for minor surgery) and recovered
* No concurrent or recent full-dose anticoagulants or thrombolytic agents (except as required to maintain patency of preexisting, permanent indwelling IV catheters)
* No concurrent chronic daily aspirin (more than 325 mg/day) or nonsteroidal anti-inflammatory medications known to inhibit platelet function