Chemoradiation With Gemcitabine in Combination With Panitumumab for Patients With Locally Advanced Pancreatic Cancer

Inclusion Criteria:

* Histological or cytological confirmed pancreatic cancer.
* Not eligible for curative resection.
* No distant metastases present.
* Previously untreated with chemotherapy and anti-cancer biologicals for current malignancy.
* No other current malignant disease, except for basal cell carcinoma of the skin.
* Measurable or evaluable disease as defined by RECIST 1.1 criteria.
* Performance status 0-2 Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) Scale.
* Age ≥ 18 years.
* Adequate haematological and biological functions:

  * Bone marrow function:

    1. Neutrophils ≥ 1.5 x 109/L
    2. Platelets ≥ 100 x 109/L
    3. Hb ≥ 6 mmol/L
  * Hepatic function:

    1. AST/ALT and alkaline phosphatase (ALP) ≤ 2.5 x institutional upper limit of normal (ULN)
    2. Bilirubin ≤ 1.5 times institutional ULN
  * Renal function:

eGFR \>50ml/min

• Metabolic Function:

1. Magnesium ≥ lower limit of normal
2. Calcium ≥ lower limit of normal.

   * No imminent bowel obstruction.
   * No active bleeding.
   * No uncontrolled infection.
   * Patients with reproductive potential must use effective contraception. Female patients must have a negative pregnancy test.
   * Signed informed consent.

Exclusion Criteria:

* Participation in another therapeutic clinical study within 30 days of enrollment or during this clinical study.
* No adequate radiation therapy possible: based on the opinion of the radiation oncologist when radiation therapy cannot be performed because radiation field is too large (PTV volume too large or OAR too high)
* History of allergic reactions to gemcitabine or antibody treatment.
* Presence of any serious concomitant systemic disorders incompatible with the clinical study (e.g. uncontrolled inter-current illness including ongoing or active infection, uncontrolled hypertension).
* Clinically significant cardiovascular disease (including myocardial infarction, unstable angina, symptomatic congestive heart failure, serious uncontrolled cardiac arrhythmia) within 1 year before enrolment/randomization
* History of interstitial lung disease e.g. pneumonitis or pulmonary fibrosis or evidence of interstitial lung disease on baseline chest CT scan
* Presence of any significant central nervous system or psychiatric disorder(s) that would hamper the patient's compliance.
* Pregnant or breastfeeding women.
* Absence of adequate contraception for both male and female fertile patients for the duration of the study; and also for six months after last treatment.
* Known positive status for HIV and/or hepatitis B or C.
* Any reason why, in the investigator's opinion, the patient should not participate in the study.
* Drug or alcohol abuse.