Inclusion Criteria:

- Histologically or cytologically confirmed adenocarcinoma of the pancreas

- Locally advanced or metastatic disease

- Radiographic evidence of disease

- No known brain metastases

- Performance status - ECOG 0-2

- More than 3 months

- WBC ≥ 3,000/mm^3

- Absolute neutrophil count ≥ 1,500/mm^3

- Platelet count ≥ 100,000/mm^3

- Bilirubin ≤ 1.5 times upper limit of normal (ULN)

- AST and ALT ≤ 2.5 times ULN (5 times ULN if liver metastases are present)

- Creatinine ≤ 1.5 mg/dL

- Creatinine clearance ≥ 50 mL/min

- No symptomatic congestive heart failure

- No unstable angina pectoris

- No cardiac arrhythmia

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- Fasting serum cholesterol ≤ 350 mg/dL

- Fasting triglycerides ≤ 400 mg/dL

- No ongoing or active infection

- No psychiatric illness or social situation that would preclude study compliance

- No other concurrent uncontrolled illness

- No concurrent prophylactic hematopoietic colony-stimulating factors

- No prior chemotherapy for metastatic pancreatic cancer

- More than 2 months since prior adjuvant or neoadjuvant chemoradiotherapy for resected
pancreatic cancer

- Must have radiographic evidence of recurrent disease

- More than 2 months since prior chemoradiotherapy for locally advanced pancreatic
cancer

- Must have radiographic evidence of disease progression

- See Chemotherapy

- See Chemotherapy

- No other concurrent investigational or commercial agents or therapies for the
malignancy

- No other concurrent anticancer therapy

- No concurrent combination antiretroviral therapy for HIV-positive patients