Inclusion Criteria:

- Only advanced carcinomas defined as unresectable or metastatic that are
histologically or cytologically confirmed to be biliary tract, pancreas, duodenal, or
ampullary carcinomas will be included.

- Dose-escalation: Patients > 18 years of age with biopsy-confirmed advanced biliary
tract adenocarcinoma, pancreas cancer, duodenal cancer, or ampullary cancer

- MTD expansion cohort: Patients > 18 years of age with biopsy-confirmed advanced
biliary tract adenocarcinoma only.

- No prior chemotherapy or prior EGF receptor inhibitor therapy

- Measurable tumor by imaging examination

- Performance status (PS) 0-2 on the ECOG performance scale

- Have pretreatment bilirubin<2.5x upper limit of normal (ULN), serum creatinine<1.5x
ULN, AST and ALT <2.5xULN or in the presence of liver metastasis <5xULN,
neutrophils>1500, platelets>100K, hemoglobin >9 g/dL

- Patients - both males and females - with reproductive potential (ie, menopausal for
less than 1 year and not surgically sterilized) must practice effective contraceptive
measures throughout the study. Women of childbearing potential must provide a
negative pregnancy test (serum or urine) within 14 days prior to registration.

- Have the ability to understand the requirements of the study and provide informed
consent

Exclusion Criteria:

- CNS metastases

- Uncontrolled infection

- Pregnant or nursing women may not participate.

- No other prior malignancy is allowed except for the following: adequately treated
basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated
Stage I or II cancer from which the patient is currently in complete remission, or
any other cancer from which the patient has been disease-free for 5 years.

- Psychiatric illness that would prevent understanding the nature of the
investigational therapy and complying with protocol requirements

- Patients with > grade 2 neuropathy

- Patients with > grade 2 uncontrolled nausea and vomiting despite antiemetics

- Any concurrent medical condition that, in the judgment of the investigator, would
make the patient an inappropriate candidate for study enrollment

- Prior chemotherapy or EGFR inhibitor