Phase II Trial to Evaluate Gemcitabine and Etoposide for Locally Advanced or Metastatic Pancreatic Cancer

Inclusion Criteria:

* Patients with locally advanced or metastatic adenocarcinoma of the pancreas.
* Patients may have received prior immunotherapy, radiation therapy, or surgery, but must be \> 4 weeks out from therapy and have recovered fully from its effects.
* Patients must be 18 years of age or older.
* Patients must have unidimensional measurements obtainable using RECIST criteria (see Protocol Attachment E).
* Karnofsky Performance Scale must be 50 or better (see Protocol Attachment A).
* Patient must have the following hematologic and chemical parameters:

  * ANC \> 1,000 cells/mm3
  * Hemoglobin \> 9 gm/dL
  * Platelets \> 100,000 cells/mm3
  * SGOT/SGPT \< 3 x normal, unless there is known liver involvement. Then they must be \< 5x normal.
  * Bilirubin \< 2.0 mg/dL
  * Creatinine \< 2.0 mg/dL
* Female within childbearing years must use an accepted contraceptive method.
* Patient must have a life expectancy of at least eight (8) weeks.
* A signed informed consent must be obtained prior to study entry.

Exclusion Criteria:

* Previous chemotherapy with the exception of 5FU given as part of an adjuvant regimen.
* Pregnant or nursing females.
* Concurrent radiation therapy.
* Patients with other active neoplasms are ineligible.
* Patients with serious active infections or other underlying medical conditions, which would impair their ability to receive the treatment as prescribed.

Disease Diagnostic Criteria and Staging:

* Patients must have a histologic or cytologic diagnosis of locally advanced or metastatic adenocarcinoma of the pancreas using standard pathologic criteria.
* Staging will be according to AJCC criteria.