Efficacy of Doxycycline on Metakaryote Cell Death in Patients With Resectable Pancreatic Cancer

Inclusion Criteria:

* Histologically or cytologically confirmed pancreatic adenocarcinoma which may be acquired using a fine needle aspiration.
* Not received any prior therapy.
* Established resectable pancreatic cancer based on radiographic imaging.
* Patients who will receive neoadjuvant therapy (chemoradiation) are eligible.
* Age ≥18 years.
* Eastern Cooperative Oncology Group (ECOG) performance status ≤2 (Karnofsky ≥60%).
* Have no active or chronic infection with HIV, Hepatitis B or Hepatitis C
* Life expectancy of greater than six months.
* Ability to understand and the willingness to sign a written informed consent document.
* Normal organ and marrow function as defined below:

  1. leukocytes ≥3,000/microliter (mcL)
  2. absolute neutrophil count ≥1,500/mcL
  3. platelets ≥100,000/mcL
  4. total bilirubin \< 2 mg/dL or has demonstrated progressive decline within two weeks of biliary decompression to allow for appropriate gemcitabine dose modification.
  5. Aspartate Aminotransferase (AST)\[Serum Glutamic Oxaloacetic Transaminase (SGOT\] )/ Alanine Aminotransferase (ALT) \[Serum Glutamic Pyruvic Transaminase(SGPT)\] ≤3 × institutional upper limit of normal
  6. Creatinine clearance ≥60 mL/min/1.73 m\^2

Exclusion Criteria:

* Patients with more clinically advanced pancreatic cancer (borderline resectable, locally advanced, or metastatic).
* Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
* Pregnant women are excluded from this study because the effects of metakaryocidal agents have the potential for teratogenic or abortifacient effects.
* Previous history of other malignancy (other than cured basal or squamous cell carcinoma of the skin or cured in-situ carcinoma of the cervix) within two years of study enrollment.
* Active or chronic HIV, hepatitis B or hepatitis C.
* Patients who are receiving other investigational drugs or enrolled in other clinical trials.
* Inability to undergo scheduled blood acquisition per protocol.
* Drug specific exclusion including history of allergic reactions to tetracyclines.
* Prior treatment with doxycycline within a seven day washout period prior to initiating treatment with alternate antimetakaryocidal medication.