Inclusion Criteria:

- Histopathologically confirmed differentiated thyroid carcinoma of follicular cell
origin, including any of the following histologies and their respective variants:

- Papillary

- Follicular

- Hürthle cell

- Must have surgically inoperable and/or recurrent or metastatic disease

- At least one fludeoxyglucose F 18 (FDG)-PET-avid lesion, defined as any focus of
increased FDG uptake > normal mediastinal activity with standard uptake variable
(SUV) maximum levels ≥ 3, as documented by baseline PET scan

- Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by
conventional techniques or ≥ 10 mm by spiral CT scan

- Progressive disease, defined by ≥ 1 of the following occurring during or after prior
treatment (e.g., radioactive isotope [RAI] treatment):

- Presence of new or progressive lesions on CT scan or MRI

- New lesions on bone scan or PET scan

- Rising thyroglobulin level documented by a minimum of 3 consecutive rises, with
an interval of > 1 week between each determination

- No known history of brain metastasis

- ECOG performance status (PS) 0-2 OR Karnofsky PS 60-100%

- ANC ≥ 1,500/mcL

- Platelet count ≥ 75,000/mcL

- WBC ≥ 3,000/mcL

- Total bilirubin ≤ 1.5 times upper limit of normal(ULN)

- AST and ALT ≤ 2.5 times ULN (≤ 5 times ULN for liver metastases)

- Creatinine ≤ 1.5 times ULNOR creatinine clearance ≥ 60 mL/min

- INR ≤ 1.2 (≤ 1.5 times ULN if on prophylactic-dose anticoagulation)

- Urine protein: creatinine ratio < 1 OR 24-hour urine protein < 500 mg

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception during and for ≥ 6 months after
completion of study therapy

- Documentation of systolic blood pressure ≤150 mm Hg and diastolic blood pressure ≤100
mm Hg

- No known hypersensitivity to Chinese hamster ovary cell products or other recombinant
human antibodies

- No history of allergic reactions attributed to compounds of similar chemical or
biologic composition to other agents used in the study

- No serious or non-healing wound, ulcer, or bone fracture

- No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess in the
past 28 days

- No significant traumatic injury within the past 28 days

- No clinically significant cardiovascular disease, defined as any of the following:

- Cerebrovascular accident within the past 6 months

- Myocardial infarction within the past 6 months

- Coronary artery bypass grafting or unstable angina within the past 6 months

- NYHA grade III-IV congestive heart failure

- Canadian Cardiovascular Class grade III or greater angina within the past 6
months

- Clinically significant peripheral vascular disease within the past 6 months

- Pulmonary embolism, deep-vein thrombosis, or other thromboembolic event within
the past 6 months

- Uncontrolled coronary artery disease, angina, congestive heart failure, or
ventricular arrhythmia requiring acute medical management

- Myocardial infarction, cerebrovascular accident, or transient ischemic attack
within the past 6 months

- No evidence of bleeding diathesis or coagulopathy within the past 12 months

- No uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection or psychiatric illness or social situation that would limit study
compliance

- No known HIV positivity

- See Disease Characteristics

- Recovered from prior therapy

- No prior VEGF-targeted antibody therapy (e.g., bevacizumab or aflibercept)

- More than 4 weeks since prior systemic therapy or radiotherapy

- More than 7 days since prior core biopsy

- Up to 1 prior targeted biologic agent (e.g., small-molecule tyrosine kinase inhibitor
or histone deacetylase inhibitor) allowed provided treatment was stopped ≥ 4 weeks
prior to initiation of therapy on this study

- Up to 1 prior cytotoxic chemotherapy (e.g., doxorubicin hydrochloride) allowed
provided treatment was stopped ≥ 4 weeks prior to initiation of therapy on this study

- Prior systemic chemotherapy administered as part of initial definitive treatment
(e.g., as a radiation sensitizer or as initial adjuvant therapy) allowed provided
treatment was stopped ≥ 3 months prior to initiation of therapy on this study and
does not count in the determination of prior targeted or cytotoxic therapy

- At least 2 weeks since prior cyclooxygenase-2 (COX-2) inhibitors, cis-retinoic acid,
or complementary medications if given with anti-cancer intent

- Medications given for a specific clinical indication (e.g., daily aspirin status
post myocardial infarction or COX-2 inhibitors at standard
anti-inflammatory/pain doses) may be continued based on the clinical judgment of
the involved investigator

- Prior RAI therapy allowed provided it was stopped > 3 months prior to initiation of
therapy on this protocol and evidence of progression (as defined above) has been
documented in the interim

- A diagnostic study using < 10 mCi of RAI is not considered RAI therapy

- Prior external-beam radiotherapy to index lesions allowed provided there has been
documented progression by RECIST criteria and at least 4 weeks have elapsed

- At least 4 weeks since prior external-beam radiation therapy to non-index
lesions

- At least 4 weeks since prior surgery

- Concurrent therapeutic-dose anticoagulants (e.g., warfarin) with PT INR > 1.5 allowed
provided that both of the following criteria are met:

- In-range INR appropriate to the treatment indication (e.g., between 2 and 3 for
atrial fibrillation) AND on a stable dose of oral anticoagulant or on a stable
dose of low molecular weight heparin

- No active bleeding or pathological condition that carries a high risk of
bleeding (e.g., tumor involving major vessels or known varices)

- Patients receiving concurrent antihypertensive agents must have documentation of the
date of the last change in dosage

- No other concurrent investigational agents

- No major surgical procedure or open biopsy within the past 28 days

- No anticipation of need for major surgical procedures during the course of the study