Temsirolimus and Bevacizumab in Treating Patients With Advanced Endometrial, Ovarian, Liver, Carcinoid, or Islet Cell Cancer

Inclusion Criteria

• Histologically or cytologically confirmed endometrial (endometrioid, uterine, papillary serous carcinoma, and carcinosarcoma), ovarian (primary peritoneal/fallopian tube, serous, endometrioid, mixed, and poorly differentiated epithelial ovarian cancers [for purposes of eligibility, carcinosarcoma is considered a poorly differentiated carcinoma]), hepatocellular carcinoma, carcinoid or islet cell (neuroendocrine: well- or moderately-differentiated neuroendocrine) cancer which are locally advanced, recurrent, or metastatic
• Patients must have measurable disease; patients having only lesions measuring >= 1 cm to = 4 weeks prior to registration, if applicable
• Absolute neutrophil count (ANC) >= 1500/mm^3
• Platelets >= 75,000/mm^3
• Hemoglobin >= 9.0 g/dL
• Total bilirubin = = 2+, 24-hour urine protein should be obtained and the level should be 1.5 x ULN can be started on lipid lowering agents and reevaluated within 1 week; if levels go to = 2 cm, and either serum alpha-fetoprotein (AFP) > 400 ng/ml, or
• AFP > three times normal and doubling in value in the antecedent 3 months
• Child-Pugh A (= = 4 weeks from treatment and show progressive disease in the liver after regional therapy or must have measurable disease outside the liver
• Concomitant anti-viral therapy is allowed
• History of prior varices or evidence of varices on pre-study CT/magnetic resonance imaging (MRI) imaging are required to undergo endoscopy = = 2 months prior to study entry with documentation of progressive disease on current dose
• Islet cell tumor cohort: prior and/or concurrent long-acting somatostatin analogue therapy is allowed, but not required; if patient is continued on a long-acting somatostatin analogue, a stable dose for >= 2 months prior to study entry is required with documentation of progressive disease on current dose
• Prior therapies allowed include:
• = = 4 weeks prior to registration
• Radiolabeled octreotide therapy (patients with prior radiolabeled octreotide therapy should have progressive disease after such therapy)
• Other investigational therapy NOTE: islet Cell Single Agent Bevacizumab Cohort: Prior mammalian target of rapamycin (mTOR) inhibitor is allowed
• Prior regional treatments for liver metastasis are permitted including:
• Selective internal radiation therapy such as brachytherapy, cyberknife, radiolabeled microsphere embolization, etc.
• Hepatic artery chemoembolization
• Hepatic artery embolization
• Hepatic artery infusional chemotherapy
• Radiofrequency ablation NOTE: patients must be >= 12 weeks from treatment and show progressive disease in the liver after regional therapy or must have measurable disease outside the liver

Exclusion Criteria

• Prior therapy with vascular endothelial growth factor receptor (VEGFR) targeting agents or mammalian target of rapamycin (mTOR) inhibitors (except as in HCC and in the Islet cell single agent bevacizumab alone cohort where prior mTOR inhibitor is allowed); Note: prior use of bevacizumab is not allowed in any cohort
• Invasive procedures defined as follows:
• Major surgical procedure, open biopsy or significant traumatic injury = = 150 mmHg systolic and/or >= 90 mmHg diastolic)
• Patient is on angiotensin-converting-enzyme (ACE) inhibitors (benazapril, captopril, enalopril, fosonopril, lisinopril, moexipril, perindopril, quinopril, ramipril, and trandolapril); (patients may have an alternate antihypertensive substituted); NOTE: ACE inhibitors are allowed in single agent bevacizumab cohort
• Currently active, second malignancy other than non-melanoma skin cancers; NOTE: patients are not considered to have a 'currently active' malignancy if they have completed anti-cancer therapy and are considered by their physician to be at less than 30% risk of relapse
• Any of the following, as this regimen may be harmful to a developing fetus or nursing child:
• Pregnant women
• Breastfeeding women
• Men or women of childbearing potential or their sexual partners