Study of Gemcitabine/Taxotere/Xeloda (GTX) in Combination With Cisplatin and Irinotecan in Subjects With Metastatic Pancreatic Cancer

The study is being done in 2 parts. The first part is the dose escalation part where the dose
of irinotecan is increased until the highest safe dose of irinotecan is defined that can be
given with gemcitabine, taxotere, xeloda, and cisplatin.

After the safe dose of irinotecan in combination with gemcitabine, taxotere, xeloda, and
cisplatin is defined, the second part will use these defined doses to look at how effective
these drugs are against advanced pancreatic cancer.

Inclusion Criteria:

1. Histologically or cytologically confirmed untreated metastatic pancreatic
adenocarcinoma.

2. Have measurable disease.

3. Male or non-pregnant and non-lactating female of age >18 years.

4. ECOG performance status of 0 to 1 . ECOG 0 indicates that the patient is fully active
and able to carry on all pre-disease activities without restriction; and, ECOG 1
indicates that the patient is restricted in physically strenuous activity but is
ambulatory and able to carry out work of a light or sedentary nature

5. Subjects must have adequate organ and marrow function.

6. Must use acceptable form of birth control prior to study and and for the duration of
study.

7. Willing and able to comply with study procedures

Exclusion Criteria:

1. Patient who have had any prior chemotherapy within 5 years of enrollment.

2. Patient who have had radiotherapy for pancreatic cancer.

3. Age ≥ 76 years

4. Patient who is receiving or have received any other investigational agents within 28
days prior to Day 1 of treatment in this study.

5. Patient who has undergone major surgery, other than diagnostic surgery within 28 days
prior to Day 1 of treatment in this study.

6. Patient who has known brain metastases.

7. Patient with history of hypersensitivity or allergic reactions attributed to compounds
of similar chemical or biologic composition to gemcitabine, taxotere, xeloda,
cisplatin, or irinotecan.

8. Patient with uncontrolled intercurrent illness including, but not limited to,
uncontrolled infection, symptomatic congestive heart failure, unstable angina
pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would
limit compliance with study requirements

9. Patient who has serious medical risk factors involving any of the major organ systems.

10. Patient who has known history of infection with HIV, hepatitis B, or hepatitis C.

11. Pregnant or breast feeding.

12. Patient is unwilling or unable to comply with study procedures

13. Patient with clinically significant wound