Nab-paclitaxel in Combination With Gemcitabine in Fragile Patients With Advanced Pancreatic Cancer

Inclusion Criteria:

* Patients who are 18 years or older;
* Patients with histological or, if not possible, cytologic confirmed adenocarcinoma of the pancreas.
* Patients with metastatic pancreatic cancer;
* Patient with an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) = 2
* Adequate hematopoietic, hepatic and renal function:
* Neutrophil count \>= 1.5 x 10\*9/L;
* Platelet count \>= 100 x 10\*9/L;
* Bilirubin \<= 1.5 x ULN;
* AST and/or ALT \<= 2.5 x ULN;
* Serum creatinine \<= 1.5 x ULN.
* Investigators must ensure that patients enrolled in the study will be available for all study procedures, including tumor biopsy, chemotherapy treatment, and follow up.
* Investigators must ensure that patients have the ability to understand the requirements of the study and provide signed informed consent.
* Women of childbearing potential and men who wish to participate in the study must agree to use adequate contraception since the signing of informed consent until at least 3 months after stopping the study medication;
* Signed Informed Consent.

Exclusion Criteria:

* Active or uncontrolled infections or serious illnesses or medical conditions that could interfere with patient eligibility for treatment;
* History of any psychiatric condition that might impair patient?s ability to understand or to comply with the requirements of the study or to provide informed consent;
* Concurrent anticancer therapy;
* Pregnant or breast-feeding women (documented methods of birth control are required in those with reproductive potential);
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to study drugs;
* History of life threatening reaction to gemcitabine or abraxane;
* Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) \<=1.
* Previous treatment with chemotherapy or chemoradiotherapy for advanced pancreatic cancer.