OBJECTIVES:

• Compare the 1-year survival rate in patients with locally advanced pancreatic cancer treated with paclitaxel, gemcitabine, and radiotherapy with or without tipifarnib.
• Determine the toxicity and loco-regional activity of this chemoradiotherapy regimen in these patients.
• Determine the feasibility and toxicity of prolonged administration of tipifarnib after chemoradiotherapy in these patients.
• Determine whether tipifarnib administered after chemoradiotherapy can increase progression-free and overall survival in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to weight loss in the preceding 6 months (more than 10% vs 10% or less) and tumor dimension (at least 5 cm vs less than 5 cm). Patients are randomized to 1 of 2 treatment arms.

• Arm I: Patients receive radiotherapy once daily, 5 days a week, for 5.5 weeks, beginning on day 1. Patients also receive paclitaxel IV over 1 hour and gemcitabine IV over 30 minutes on days 1, 8, 15, 22, 29, and 36.
• Arm II: Patients receive chemoradiotherapy as in arm I. Within 3-8 weeks after completion of chemoradiotherapy, patients without disease progression receive oral tipifarnib twice daily for 21 days. Treatment continues every 28 days in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 154 patients (77 per treatment arm) will be accrued for this study within approximately 20 months.

DISEASE CHARACTERISTICS:

• Histologically confirmed unresectable, locally advanced adenocarcinoma of the pancreas

  • Residual disease after resection (R1 or R2, microscopic or macroscopic) allowed
• No metastases in major viscera
• No peritoneal seeding or ascites
• Biliary or gastroduodenal obstruction must have drainage before starting study therapy
• Radiographically assessable disease encompassable within a single irradiation field (15 by 15 cm maximum)

PATIENT CHARACTERISTICS:

Age:

• Not specified

Performance status:

• Zubrod 0-1

Life expectancy:

• Not specified

Hematopoietic:

• Granulocyte count at least 1,800/mm^3
• Platelet count at least 100,000/mm^3

Hepatic:

• ALT less than 3 times upper limit of normal
• Bilirubin less than 2.0 mg/dL

Renal:

• Creatinine less than 3.0 mg/dL

Other:

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No other malignancy within the past 2 years except non-melanoma skin cancer or carcinoma in situ of the cervix, uterus, or bladder
• No significant infection or other medical condition that would preclude study

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• No prior chemotherapy (including gemcitabine or paclitaxel) for pancreatic cancer
• No other concurrent cytotoxic agents

Endocrine therapy:

• Not specified

Radiotherapy:

• See Disease Characteristics
• No prior radiotherapy to the planned field
• No other concurrent radiotherapy

Surgery:

• See Disease Characteristics

Other:

• No other concurrent investigational agents