Combination Chemotherapy With or Without Ganitumab in Treating Patients With Previously Untreated Metastatic Pancreatic Cancer

DISEASE CHARACTERISTICS:

* Histologically or cytologically confirmed pancreatic ductal adenocarcinoma
* Metastatic disease to distant sites, as documented by CT scan or MRI

  * Patients with locally advanced disease are NOT eligible
* At least one site of disease measurable by RECIST 1.1 criteria; defined as lesions that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 2 cm with conventional techniques or as ≥ 1 cm with spiral CT scan
* No known CNS metastases or carcinomatous meningitis, as determined by physical examination and/or imaging studies
* No suspected Gilbert syndrome or known homozygosity for the UGT1A1\*28 allele (UGT1A1 genotyping is not required for enrollment on this study; however, patients known to be homozygous for the UGT1A1\*28 allele are excluded)

PATIENT CHARACTERISTICS:

* ECOG performance status 0 or 1
* Neutrophils ≥ 1,500/μL
* Platelet count ≥ 100,000/μL
* Creatinine ≤ 1.5 mg/dL OR creatinine clearance ≥ 60 mL/min
* Total bilirubin ≤ 1.5 x upper limit of normal (ULN)
* AST (SGOT) and ALT (SGPT) ≤ 2.5 x ULN
* INR ≤ 1.5
* Blood glucose level ≤ 160 mg/dL

  * Patients with non-fasting blood glucose \> 160 mg/dL must have a fasting blood glucose ≤ 160 mg/dL to be eligible
  * Patients with diabetes mellitus are allowed at the discretion of the treating investigator, if blood sugars are felt to be under appropriate control
* Not pregnant or nursing
* Negative serum or urine pregnancy test
* No malignancy (other than non-melanoma skin cancer or carcinoma in situ of the cervix) diagnosed within the past 3 years or any currently active malignancy

  * A malignancy is considered not "active" if all anti-cancer therapies were completed \> 3 years before enrollment and there is no current evidence of persistent disease
* No neurosensory or neuromotor toxicity ≥ grade 2
* No known allergy to platinum compounds or E. coli-derived products (e.g., filgrastim, humulin, insulin, or L-asparaginase)
* No colonic or small bowel disorders with uncontrolled symptoms at baseline (for example, \> 3 watery or soft stools daily in patients without colostomy or ileostomy)

  * Patients with colostomy or ileostomy can be enrolled at the discretion of the investigator
* No history of stroke, unstable angina, myocardial infarction, or ventricular arrhythmia requiring medication or mechanical control within 6 months of registration
* No HIV-positive patients with a prior history of AIDS-defining illness

  * No HIV-positive patients with a CD4 count of \< 450 cells/mm³ at any point prior to study
  * Anti-retroviral therapy must be discontinued during study treatment
* No known positivity for chronic infection with B virus (HBV)

PRIOR CONCURRENT THERAPY:

* Prior treatment with chemotherapy or radiotherapy for resected, locally advanced or metastatic pancreatic cancer is NOT allowed
* No prior treatment with inhibitors of the insulin-like growth factor 1 receptor
* No prior treatment with radiotherapy to greater than 25% of bone marrow
* Palliative radiation therapy may NOT be administered while a subject is on the study
* No major surgery within 4 weeks of the start of study treatment

  * Patients must have recovered from the side effects of any major surgery at the start of study treatment
  * Major surgery is defined as those surgeries that require general anesthesia

    * Insertion of a vascular access device or endobiliary stent is NOT considered major surgery
* No percutaneous biliary drain (endobiliary stents are allowed)
* Warfarin for INR goal \> 1.5 is prohibited

  * Patients on warfarin with INR goal of ≤ 1.5 are eligible
* Hormones or other chemotherapeutic agents may NOT be administered except for steroids given for adrenal failure; hormones administered for non-disease-related conditions (e.g., insulin for diabetes); and intermittent use of dexamethasone as an antiemetic or for the prevention or treatment of ganitumab infusion reactions
* Patients receiving anti-retroviral therapy must discontinue such therapy while receiving study treatment