Study of Gemcitabine and Abraxane to Treat Potentially Operable Pancreatic Cancer

Inclusion Criteria:

1. Patient has histologically or cytologically confirmed potentially resectable adenocarcinoma of the pancreas. Patients with islet cell neoplasms are excluded.

   Definition of potentially operable disease
   1. Staging by high-quality, pancreatic protocol, helical abdominal computed tomography required (Endoscopic ultrasound is not required).
   2. No extension to superior mesenteric artery (SMA) and hepatic artery.
   3. Clear fat plane between the SMA and celiac axis.
   4. No extension to celiac axis and hepatic artery.
   5. Patent superior mesenteric vein and portal vein.
   6. No evidence of distant or extra-hepatic disease by CT scans.
   7. Pretreatment histological or cytological confirmation of an adenocarcinoma.
2. Male or non-pregnant and non-lactating female, and ≥ 18 years of age.
3. If a female patient is of child-bearing potential, she must have a negative serum pregnancy test (β hCG) documented within 72 hours of the first administration of study drug.
4. If sexually active, the patient must agree to use contraception considered adequate and appropriate by the Investigator.
5. Patient must have received no prior chemotherapy or radiation for pancreatic cancer and no exposure to gemcitabine and/or Abraxane
6. Patient has the following blood counts at baseline:

   1. ANC ≥ 1.5 x 109/L (1500 /mm³);
   2. Platelets ≥ 100 x 109/L; (100,000/mm³);
   3. Hgb ≥ 10 g/dL.
7. Patient has the following blood chemistry levels at baseline:

   1. AST (SGOT), ALT (SGPT) ≤ 2.5 x upper limit of normal (ULN);
   2. Alkaline phosphatase (AP) ≤ 2.5 X ULN;
   3. Total bilirubin ≤1.5 mg/dl;
   4. Serum creatinine ≤1.5mg/dl or calculated clearance ≥ 50 mL/min/1.73 m² for patients with serum creatinine levels \>1.5 mg/dl.
8. Patient has acceptable coagulation status as indicated by a PT within normal limits (±15%) and PTT within normal limits (± 15%).
9. Patient has an ECOG performance status PS 0-1.
10. Patient has been informed about the nature of the study, and has agreed to participate in the study, and signed the Informed Consent Form prior to participation in any study-related activities.

Exclusion Criteria:

1. Patient has borderline resectable disease
2. Patient uses therapeutic coumadin for a history of pulmonary emboli or DVT.
3. Patient has active, uncontrolled bacterial, viral, or fungal infection(s) requiring systemic therapy.
4. Patient has known infection with HIV, hepatitis B, or hepatitis C.
5. Patient has undergone major surgery, other than diagnostic surgery (i.e.--surgery done to obtain a biopsy for diagnosis without removal of an organ), within 4 weeks prior to Day 1 of treatment in this study.
6. Prior chemotherapy or radiation for pancreatic cancer. Prior exposure to gemcitabine and/or Abraxane.
7. Patient has a history of allergy or hypersensitivity to the study drugs.
8. Patient has serious medical risk factors involving any of the major organ systems such that the Investigator considers it unsafe for the patient to receive an experimental research drug.
9. Patient is unwilling or unable to comply with study procedures.
10. Patient is enrolled in any other therapeutic clinical protocol or investigational trial.
11. Patient has metastatic disease on radiological staging.
12. Patients aged ≥ 80 are not excluded. As two events of fatal sepsis have been seen in this group in other studies, candidates in this age group should be thoroughly evaluated before enrollment in the study, to ensure they are fit to receive chemotherapy. In addition to meeting all of the baseline patient selection criteria, clinical judgment on their susceptibility to infection and expected stability of their performance status as to receive repeat weekly chemotherapy cycles, should be paid special attention to. Patients should not be enrolled in the study should there be any hesitation on any of these considerations. Baseline criteria for all patients enrolled on the study must be carefully evaluated and all criteria followed appropriately.