Individualized Drug Treatment Selection Process for Treating Patients With Pancreatic Cancer That Can Be Removed By Surgery

DISEASE CHARACTERISTICS:

• Suspected adenocarcinoma of the pancreas with resectable disease (part I)

  • Scheduled to have surgical resection at the Johns Hopkins Hospital
• Participation in part I of the study with informative mouse xenograft data (part II)

• Histologically or cytologically confirmed diagnosis of adenocarcinoma of the pancreas not amenable to curative treatment (part II)

  • The following diagnoses are ineligible:

    • Adenosquamous cell
    • Islet cell
    • Cystadenoma or cystadenocarcinoma
    • Carcinoid
    • Small or large cell carcinoma or lymphoma

• Patient is ineligible if any of the following occur (part II):

  • Xenograft data is noninformative
  • Tumors do not take in the mice or do not respond to any of the selected agents
  • Disease progression occurs before mice data is available
• No adenocarcinoma arising from a site other than the pancreas (e.g., distal common bile duct, ampulla of vater, or periampullary duodenum)
• No known brain metastases

PATIENT CHARACTERISTICS:

• ECOG performance status 0 or 1
• Life expectancy > 12 weeks
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for 30 days after study completion
• WBC > 3,500/mm^3
• Absolute neutrophil count > 1,500/mm^3
• Platelet count > 100,000/mm^3
• Hemoglobin ≥ 9 g/dL
• Creatinine ≤ 2 mg/dL
• Bilirubin ≤ 2 mg/dL
• ALT, AST, and alkaline phosphatase ≤ 5 times upper limit of normal
• No uncontrolled medical conditions that could potentially increase the risk of toxic effects or complications when treated with chemotherapy
• No gastrointestinal tract disease resulting in an inability to take oral medication
• No disease requiring IV alimentation
• No active peptic ulcer disease
• No active infections
• No history of another neoplasm except for nonmetastatic, nonmelanoma skin cancers ≤ 5 years prior to enrollment
• No unresolved chronic toxicity (except alopecia) > grade 2 from previous anticancer therapy

• Patients must not have documented history of clinically significant cardiovascular disease including any of the following:

  • Myocardial infarction within the past 12 months
  • Unstable angina
  • Peripheral vascular disease ≥ grade 2
  • Uncontrolled congestive heart failure
  • Uncontrolled hypertension (i.e., systolic blood pressure [BP] > 170 mm Hg and/or diastolic BP > 95 mm Hg)
• HIV negative
• Hepatitis B and C negative

PRIOR CONCURRENT THERAPY:

• No prior treatment for recurrent disease
• More than 30 days since prior chemotherapy
• More than 4 weeks since prior surgery (excluding minor procedures, dental work, skin biopsy, etc.)
• No prior surgical procedures affecting absorption