Gemcitabine Hydrochloride and Tanespimycin in Treating Patients With Stage IV Pancreatic Cancer

Inclusion Criteria:

* Histologically or cytologically confirmed pancreatic adenocarcinoma

  * Clinical stage IV disease
* No known brain metastases
* ECOG performance status 0-2
* Life expectancy ≥ 12 weeks
* Absolute Neutrophil Count (ANC) ≥ 1,500/mm³
* Platelet count ≥ 100,000/mm³
* Total bilirubin normal
* Aspartate aminotransferase (AST) ≤ 2.5 times upper limit of normal (ULN)
* Alkaline phosphatase ≤ 2 times ULN (5 times ULN if liver metastases are present)
* Creatinine normal
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* Ejection fraction \> 40% by echocardiogram

  * Patients who received prior anthracyclines must have a normal ejection fraction by echocardiogram
* Corrected QT interval (QTc) \< 500 msec
* Pulse oximetry \> 88% on room air at rest and after gentle exercise (according to Group Medicare Guidelines)
* No history of allergic reactions attributed to compounds of similar chemical or biologic composition to tanespimycin (17-AAG) or gemcitabine hydrochloride
* No known allergy to eggs
* No concurrent uncontrolled illness including, but not limited to, any of the following:

  * Ongoing or active infection
  * Symptomatic congestive heart failure
  * Unstable angina pectoris
  * Cardiac arrhythmia
  * Psychiatric illness/social situations that would limit compliance with study requirements
* No active ischemic heart disease within the past 12 months
* No history of uncontrolled dysrhythmias
* No congenital long QT syndrome
* No left bundle branch block
* No other significant cardiac disease, including any of the following:

  * New York Heart Association class III or IV heart failure
  * Myocardial infarction within the past year
  * Poorly controlled angina
  * Uncontrolled dysrhythmias
  * History of serious ventricular arrhythmia (ventricular tachycardia or ventricular fibrillation ≥ 3 beats in a row)
* No clinically significant interstitial lung disease
* No symptomatic pulmonary disease requiring medication, including any of the following:

  * Dyspnea
  * Dyspnea on exertion
  * Paroxysmal nocturnal dyspnea
  * Significant pulmonary disease requiring oxygen\*, including chronic obstructive/restrictive pulmonary disease
* No pulmonary or cardiac symptoms ≥ grade 2
* No history of cardiac or pulmonary toxicity after receiving anthracyclines (e.g., doxorubicin hydrochloride, daunorubicin hydrochloride, mitoxantrone hydrochloride, bleomycin, or vincristine)
* No prior chemotherapy for metastatic disease
* No prior radiotherapy to the chest
* No prior radiotherapy that potentially included the heart in the field (e.g.,mantle radiotherapy)
* More than 3 months since prior adjuvant chemotherapy or chemotherapy for locally advanced disease
* More than 3 weeks since prior radiotherapy
* No concurrent medications that prolong or may prolong QTc
* No concurrent antiarrhythmic drugs
* No concurrent prophylactic colony-stimulating factors
* No other concurrent investigational agents
* No other concurrent anticancer therapy