Everolimus and Octreotide Acetate With or Without Bevacizumab in Treating Patients With Locally Advanced or Metastatic Pancreatic Neuroendocrine Tumors That Cannot Be Removed by Surgery

You may be eligible if

• Patients must have histologic documentation of well-differentiated or moderately differentiated neuroendocrine tumor from either a primary or metastatic site
• * If different histologic classification schemes are used, equivalent histologic classifications (for example "grade 1", "low-grade", or "intermediate-grade") are allowed
• * Patients with poorly differentiated neuroendocrine carcinoma or small cell carcinoma are excluded
• * Documentation from a metastatic disease site is sufficient if there is clinical evidence of a pancreatic primary site
• Locally unresectable or metastatic disease
• Patients must have either histologic documentation of a pancreatic primary site, or clinical evidence of a pancreatic neuroendocrine primary tumor as determined by the treating physician
• * Patients with neuroendocrine tumors (e.g., gastrinoma, VIPoma) in whom a pancreatic or peripancreatic primary site is strongly suspected are also eligible
• Patients must have evidence of disease (measurable or non-measurable) with evidence of progression within the past 12 months
• Measurable disease:
• Lesions that can be accurately measured in at least one dimension (longest diameter to be recorded) as \>= 2 cm with conventional techniques or as \>= 1 cm with spiral computed tomography (CT) scan
• Non-measurable disease:
• All other lesions, including small lesions (longest diameter \< 20 mm with conventional techniques or \< 10 mm with spiral CT scan) and truly non-measurable lesions; lesions that are considered non-measurable include the following:
• Bone lesions
• Leptomeningeal disease
• Ascites
• Pleural/pericardial effusion
• Inflammatory breast disease
• Lymphangitis cutis/pulmonis
• Abdominal masses that are not confirmed and followed by imaging techniques
• Cystic lesions
• * No prior treatment with bevacizumab, everolimus, or other mammalian target of rapamycin (mTOR) inhibitors
• * Other prior treatments, including but not limited to prior cytotoxic chemotherapy, alpha interferon, tyrosine kinase inhibitors, external beam radiation therapy, and radiopeptide therapy are allowed
• There is no limit on the number of prior treatment regimens
• Any prior treatment (with the exception of octreotide) must be completed at least 4 weeks prior to initiation of treatment
• * Prior treatment with embolization or ablative therapies is allowed if measurable disease remains outside of the treated area
• There is no limit on the prior number of procedures
• * Treatment with somatostatin analogs is a requirement of the study
• Patients receiving octreotide at the time of study entry may continue at the same dose level for the duration of the study
• Patients not receiving octreotide will initiate treatment according to study guidelines
• Prior progression on somatostatin analogs or a negative octreotide scan does not exclude patient participation in this study
• * Patients should have completed any major surgery \>= 4 weeks from start of treatment
• Patients must have completed any minor surgery \>= 2 weeks prior to start of treatment
• Patients must have fully recovered from the procedure
• Insertion of a vascular access device is not considered major or minor surgery
• * Patients should not receive immunization with attenuated live vaccines within one week prior to registration or during protocol therapy
• * No concurrent condition resulting in immune compromise, including chronic treatment with corticosteroids or other immuno suppressive agents
• * No clinical evidence of brain metastases or carcinomatous meningitis
• * No history of gastrointestinal (GI) perforation within 12 months prior to registration
• * No history of clinically significant bleeding episodes
• * Patients on therapeutic anticoagulation are eligible for the study provided that they are on a stable dose of anticoagulants
• * No uncontrolled diabetes mellitus
• * Patients with a history of severely impaired lung function as defined as spirometry and diffusing capacity of the lung for carbon monoxide (DLCO) that is 50% of the normal predicted value and/or oxygen (O2) saturation that is 88% or less at rest on room air are excluded
• * Patients with fasting serum cholesterol \>= 300 mg/dL OR \>= 7.75 mmol/L AND fasting triglycerides \>= 2.5 X upper limit of normal (ULN) should initiate lipid-lowering medications with the goal of achieving levels below these thresholds
• * No history of intolerance or allergies to octreotide
• * Patients with a history of hypertension must be adequately controlled (baseline blood pressure \[BP\] \< 150/90 mm Hg) on antihypertensives
• * No current congestive heart failure (New York Heart Association class II, III, or IV)
• * No symptomatic arterial peripheral vascular disease
• * No history of aortic aneurysm, aortic dissection, angina, myocardial infarction, stroke, or other arterial thrombotic events within 6 months of registration
• * Eastern Cooperative Oncology Group (ECOG) performance status 0-1
• * Women must not be pregnant or lactating; both men and women of childbearing potential must be advised of the importance of using effective birth control measures during the course of the study
• * Granulocytes \>= 1,500/uL
• * Platelets \>= 100,000/uL
• * Creatinine =\< 1.5 x upper limit of normal
• * Bilirubin =\< 1.5 x upper limit of normal
• * Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =\< 2.5 x upper limit of normal (=\< 5 x upper limit of normal if liver metastases present)
• * Urine protein =\< 1+ OR urine creatinine ratio =\< 1 (by urinalysis)
• If urine protein creatinine (UPC) ratio is \> 1 on urinalysis, then 24-hour urine collection for protein must be obtained and level must be \< 1,000 mg for patient enrollment