Combination Chemotherapy as First-Line Therapy in Treating Patients With Locally Advanced or Metastatic Neuroendocrine Tumors of the Duodenum or Pancreas That Cannot Be Removed By Surgery

You may be eligible if

• DISEASE CHARACTERISTICS:
• Diagnosis of neuroendocrine tumor of the duodenum/pancreas by histology or bone scan
• Functional or nonfunctional tumor
• * Tumor meets ≥ 1 of the following criteria:
• * Hepatic or extrahepatic metastases
• * Progressive locally advanced tumor (primary or adenopathies)
• Unresectable disease
• Tumor differentiated and meets the following criteria:
• * Ki 67 ≤ 15%
• * Less than 10 mitoses per 10 large fields
• Measurable or evaluable disease
• * Target lesions must meet 1 of the following criteria within the past 6 months:
• * Increase of 20% in the longest diameter
• * New metastases detected
• * Minimum size of lesions must be 1 of the following:
• * More than 15 mm for metastases
• * More than 50 mm for primary tumor or local lymph nodes
• PATIENT CHARACTERISTICS:
• WHO performance status 0-2
• Creatinine ≤ 1.5 mg/dL
• Absolute neutrophil count ≥ 1,500/mm\^3
• Platelet count ≥ 100,000/mm\^3
• Bilirubin ≤ 1.8 mg/dL
• No coronary insufficiency or symptomatic cardiac disease
• No intestinal obstruction, enteropathy, or uncontrolled chronic diarrhea
• No Gilbert's disease
• No psychological, social, familial, or geographic condition that would preclude study treatment
• Not pregnant or nursing
• Fertile patients must use effective contraception during and for 6 months after completion of study therapy
• No other condition that would preclude study therapy
• PRIOR CONCURRENT THERAPY:
• No prior adjuvant radiotherapy
• At least 3 months since prior interferon
• Prior somatostatin analogs or antisecretories allowed
• No other prior treatment for this cancer
• No concurrent radiotherapy to the target lesion