Conatumumab, Gemcitabine Hydrochloride, Capecitabine, and Radiation Therapy in Treating Patients With Locally Advanced Pancreatic Cancer

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically or cytologically confirmed adenocarcinoma of the pancreas
• * Locally advanced disease
• * With and without regional adenopathy
• Unresectable disease based on institutional standardized criteria of unresectability OR medically inoperable
• No distant metastatic disease, second malignancy, or peritoneal seeding
• PATIENT CHARACTERISTICS:
• Zubrod performance status 0-1
• Absolute granulocyte count ≥ 1,500/mm³
• Platelet count ≥ 100,000/mm³
• Hemoglobin ≥ 8.0 g/dL (transfusion or other intervention allowed)
• Serum creatinine ≤ 1.5 mg/dL
• ALT or AST \< 3 times upper limit of normal (ULN)
• Total bilirubin \< 3.0 mg/dL
• Alkaline phosphatase \< 3 times ULN
• Amylase ≤ 2 times ULN
• Lipase ≤ 2 times ULN
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for ≥ 3 months after the last study drug administration (for women) or for ≥ 6 months after the last study drug administration (for men)
• Able to swallow oral medications
• No other invasive malignancy within the past 2 years, except for nonmelanomatous skin cancer or carcinoma in situ of the breast, oral cavity, or cervix
• No severe, active co-morbidity, including any of the following:
• * Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy within the past 30 days
• * Transmural myocardial infarction within the past 3 months
• * Unstable angina and/or congestive heart failure requiring hospitalization within the past 6 months
• * Any other cardiac condition that, in the opinion of the treating physician, would make study treatment unreasonably hazardous for the patient
• * Acute bacterial or fungal infection requiring IV antibiotics
• * Uncontrolled malabsorption syndrome significantly affecting gastrointestinal function
• * Any unresolved bowel or bile duct obstruction
• * Major resection of the stomach or small bowel that could affect the absorption of capecitabine
• * AIDS based upon current CDC definition
• * HIV testing is not required for study entry
• No prior allergic reaction to capecitabine or gemcitabine hydrochloride
• PRIOR CONCURRENT THERAPY:
• No prior radiotherapy to the region of the study cancer that would result in overlap of radiotherapy fields
• No prior treatment with TRAIL-receptor agonists
• No prior systemic chemotherapy for pancreatic cancer
• More than 2 years since prior chemotherapy for malignancies other than pancreatic cancer
• More than 28 days since prior major surgery (e.g., biliary or gastric bypass)
• * Insertion of a vascular access device, exploratory laparotomy, or laparoscopy are not considered major surgery
• No concurrent intensity-modulated radiotherapy
• No other concurrent chemotherapy
• No other concurrent monoclonal antibody therapy
• No concurrent sorivudine, brivudine A, or cimetidine
• No concurrent participation in another clinical trial
• Concurrent oral anticoagulants (e.g., warfarin) allowed provided INR is monitored