Inclusion Criteria:

To be included in this study, you must meet the following criteria:

- Metastatic poorly differentiated neuroendocrine carcinoma

- Unknown primary site

- Able to perform activities of daily living with minimal assistance

- Measurable or evaluable disease

- Adequate bone marrow, liver functions and kidney function

- No previous treatment with chemotherapy

- Understand the nature of this study and give written informed consent.

Exclusion Criteria:

You cannot participate in this study if any of the following apply to you:

- Age < 18 years

- Previous malignancy within five years

- Women pregnant or lactating

- Recent history of cardiovascular disease

- Meningeal metastases

Please note: There are additional inclusion/exclusion criteria. The study center will
determine if you meet all of the criteria. If you do not qualify for the trial, study
personnel will explain the reasons. If you do qualify, study personnel will explain the
trial in detail and answer any questions you may have.