Gemcitabine With or Without Dalteparin in Treating Patients With Locally Advanced or Metastatic Pancreatic Cancer

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically or cytologically confirmed metastatic or locally advanced adenocarcinoma of the pancreas
• * Patients with clinical 'high probability' of pancreatic cancer and biopsy suggestive but not diagnostic of pancreatic cancer may be eligible based on review by the principal investigator
• Measurable or evaluable disease
• No clinical evidence of active venous thromboembolism
• PATIENT CHARACTERISTICS:
• Karnofsky performance status (PS) 60-100% OR WHO PS 0-2
• Life expectancy \> 12 weeks
• Absolute neutrophil count \> 2,000/mm³
• WBC \> 3,000/mm³
• Platelet count \> 100,000/mm³
• Creatinine clearance \> 50 mL/min
• INR ≤ 1.5 times upper limit of normal (ULN)
• Bilirubin \< 1.5 times ULN (stent allowed)
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No cerebrovascular accident within the past 6 months
• No obvious contraindication to anticoagulation, including the following:
• * Bleeding diathesis
• * Active peptic ulcer
• * Ulcerating cancer into duodenum
• No history of other advanced malignancy
• No gross hematuria
• No melaena or gross evidence of gastrointestinal bleeding (other than piles)
• No requirement for a central line
• No other significant medial or psychiatric illness that, in the opinion of the investigator, would preclude study participation
• PRIOR CONCURRENT THERAPY:
• No prior gemcitabine hydrochloride-containing treatment
• No other concurrent cytotoxic chemotherapy, immunotherapy, hormonal therapy (excluding contraceptives and replacement steroids), or experimental medications
• No other concurrent specific anticancer therapy as a result of disease progression
• No concurrent caval filter device
• No other concurrent anticoagulants for venous thromboembolism or other reasons (e.g., atrial fibrillation)
• No concurrent acetylsalicylic acid (\> 75 mg) as an antiplatelet drug for a preexisting cardiovascular condition
• No concurrent clopidogrel bisulfate