Study to Evaluate Bi-weekly Dosing of Gemcitabine Plus Nab-Paclitaxel to Treat Metastatic Pancreatic Cancer

This study will help determine whether the occurrence of adverse events can be decreased by
moving to a bi-weekly, opposed to a weekly, dosing schedule of gemcitabine plus nab-Pacitaxel
for the treatment of unresectable/metastatic pancreatic cancer.

Inclusion Criteria:

1. Patients must have histologically-proven unresectable/metastatic pancreatic
adenocarcinoma.

2. Patient has one or more radiographically measurable tumor.

3. Patients may have received prior adjuvant chemotherapy or radiation therapy (RT).

4. Age ≥ 18 years.

5. Patient must have read, understood, and provided written informed consent and HIPAA
authorization after full explanation of the nature of the study.

6. ECOG performance status 0 - 2 and an expected survival of at least 3 months.

7. Acceptable hematological parameters within 2 weeks of commencing study therapy as
follows:

- Absolute neutrophil count (ANC) ≥ 1.5 x 10^9/L

- Platelet count ≥ 100 x 10^9/L

- Hemoglobin (Hgb) ≥ 9g/dl

8. Patients with adequate organ function as measured by:

A. Cardiac: American Heart Association Class I: Patients with cardiac disease but
without resulting limitation of physical activity. Ordinary physical activity does not
cause undue fatigue, palpitation, dyspnea, or anginal pain.

B. Hepatic: Bilirubin ≤ 2.0 mg/ and ALT and AST ≤ 1.5x the upper limit of normal.

C. Renal: Creatinine ≤ 1.5 mg/dl and no other chronic kidney disease.

9. Women must meet one of the following criteria:

- Post-menopausal for at least one year

- Surgically incapable of child-bearing

- Utilizing a reliable form of contraception for the duration of study
participation. Women of child-bearing potential must have a negative serum β-HCG
within 7 days of study drug administration.

Exclusion Criteria:

1. Previous use of nab-Paclitaxel for treatment of pancreatic cancer either as
monotherapy or combination in neo-adjuvant, adjuvant, or the metastatic setting.

2. Previous use of any chemotherapy or radiation therapy for metastatic disease.

3. Patient has known brain metastases, unless previously treated and well-controlled for
at least 3 months (defined as clinically stable, no edema, no steroids and stable in 2
scans at least 4 weeks apart).

4. Other significant active or chronic infection.

5. History of active other malignancy excluding basal or squamous cell carcinoma of the
skin or cervical intraepithelial neoplasia.

6. Pregnant or nursing females.

7. Patient has serious medical risk factors involving any of the major organ systems, or
serious psychiatric disorders, which could compromise the patient's safety or the
study data integrity.

8. Major surgery, other than diagnostic surgery within 4 weeks of study entry.

9. Patient requires a legal authorized representative for consenting.