P:II Above-Label Octreotide-LAR With Insufficiently Controlled Carcinoid Syndrome

Inclusion Criteria: * Metastatic neuroendocrine tumors that are considered well or moderately differentiated (or low to intermediate grade). Patients with poorly differentiated neuroendocrine carcinomas or small cell carcinomas are excluded from the study. * Elevated urine 5-hydroxyindoleacetic acid (5-HIAA) * More than 2 bowel-movements per day OR more than 4 flushing episodes per week on average * Patient currently on octreotide LAR 30mg every 3 or 4 weeks (for at least 3 cycles prior to screening) * Age ≥ 18 years * Minimum of four weeks since any major surgery, liver-directed therapy (embolization, etc.) or systemic cancer treatment other than octreotide LAR * Eastern Cooperative Oncology Group (ECOG) performance status ≤2 * Life expectancy \> 12 weeks * Reliable contraception should be maintained throughout the study and for 3 months after study drug discontinuation. * Signed informed consent to participate in the study must be obtained from patients after they have been fully informed of the nature and potential risks by the investigator (or his/her designee) with the aid of written information. Exclusion Criteria: * Known hypersensitivity to somatostatin analogues * Patients with poorly differentiated neuroendocrine cancers * Patients with liver cirrhosis * Patients receiving hemodialysis or peritoneal dialysis * Patients with cachexia who, in the opinion of the investigator, may have difficulty tolerating intramuscular injection * Patients with symptomatic cholelithiasis or biliary events within past five years (who have not undergone cholecystectomy) * Patients with recent history (within 5 years) of pancreatitis * Patients with uncontrolled diabetes (HgA1c \>8.0 despite adequate therapy) * Women of child-bearing potential, UNLESS they are using two birth control methods * Women who are pregnant or lactating * HIV positive patients * History of sustained ventricular tachycardia, ventricular fibrillation, advanced heart block, idiopathic syncope thought to be related to ventricular arrhythmia, or congenital long QT syndrome * Risk factors for Torsades de Pointes such as cardiac failure, clinically significant/symptomatic bradycardia * Patients who have any severe and/or uncontrolled medical conditions or other conditions that could affect their participation in the study * History of noncompliance to medical regimens or unwillingness to comply with the protocol * Patients who were unable to tolerate or did not benefit from above-label dose octreotide (\>30mg) in the past * Concomitant use of other cancer treatments or carcinoid syndrome treatments (whether standard or experimental). Patients should discontinue any concomitant cancer medications more than two weeks prior to screening.