Combining Erlotinib Plus Bevacizumab and Gemcitabine Plus Capecitabine to Treat Advanced Pancreatic Cancer

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically or cytologically confirmed adenocarcinoma of the pancreas
• Locally advanced or metastatic disease
• Not amenable to curative resection
• No invasion of adjacent organs (e.g., duodenum or stomach) by CT scan
• Unidimensionally measurable disease as assessed by CT in accordance with the Response Evaluation Criteria in Solid Tumors (RECIST) guidelines.
• No evidence of brain metastasis
• PATIENT CHARACTERISTICS:
• Age:
• 18 and over
• Performance status:
• Eastern Cooperative Oncology Group (ECOG) 0-2
• Life expectancy:
• Greater than 3 months
• Hematopoietic:
• Granulocyte count ≥ 1,500/mm\^3
• Platelet count ≥ 100,000/mm\^3
• Hepatic:
• Bilirubin ≤ upper limit of normal
• Serum albumin \> 26 g/litre
• Renal:
• Creatinine ≤ 180 micromoles/litre OR
• Creatinine clearance ≥ 50 mL/min
• Cardiovascular:
• No clinically significant cardiovascular disease
• No uncontrolled hypertension (i.e., blood pressure \> 150/90 mm Hg on medication)
• No arterial thromboembolic event within the past 6 months, including any of the following:
• * Myocardial infarction
• * Unstable angina pectoris
• * Cerebrovascular accident
• * Transient ischemic attack
• No New York Heart Association grade II-IV congestive heart failure
• No serious cardiac arrhythmia requiring medication
• OTHER:
• Not pregnant or breast feeding
• Fertile patients must use effective contraception during study participation
• No serious or non-healing wound, ulcer, or bone fracture
• No infection requiring parenteral antibiotics
• No major bleeding diathesis or coagulopathy
• No significant traumatic injury within the past 28 days
• No surgery within the last 28 days or anticipation for the need for major surgery during the course of study treatment
• No other active malignancy except non-melanoma skin cancer and cervical cancer in-situ
• No history of known dihydropyrimidine dehydrogenase (DPD) deficiency
• No lack of physical integrity of the upper gastro-intestinal tract, malabsorption syndrome, or inability to take oral medication
• PRIOR CONCURRENT THERAPY:
• No previous chemotherapy, radiotherapy or other investigational drug treatment for metastatic disease (including VEGF or EGFR antagonists)
• No previous preoperative or adjuvant chemotherapy, radiotherapy or other investigational drug treatment.
• No full dose anti-coagulation (i.e. warfarin or full dose low molecular weight heparin) prior to starting study treatment.
• No ongoing treatment with aspirin (\>325 mg/day) or other medications known to predispose to gastrointestinal ulceration