Gemcitabine Compared With Pancreatic Enzyme Therapy Plus Specialized Diet (Gonzalez Regimen) in Treating Patients Who Have Stage II, Stage III, or Stage IV Pancreatic Cancer

DISEASE CHARACTERISTICS:

• Histologically confirmed unresectable primary or metastatic adenocarcinoma of the pancreas diagnosed within the past 8 weeks

  • Stage II-IV

PATIENT CHARACTERISTICS:

Age:

• 18 to physiologic 65

Performance status:

• ECOG 0-2

Life expectancy:

• More than 2 months

Hematopoietic:

• WBC greater than 3,000/mm^3
• Platelet count greater than 100,000/mm^3

Hepatic:

• Bilirubin less than 2.5 times normal
• SGOT or SGPT less than 1.5 times normal
• Albumin greater than 3.2 g/dL

Renal:

• Creatinine less than 1.5 times normal
• BUN less than 1.5 times normal

Other:

• Not pregnant or nursing
• HIV negative
• No other serious medical or psychiatric illness that would preclude study participation
• No serious infection
• Ability to eat solid food three meals per day
• No allergy or intolerance to pork
• No prior illicit drug addiction
• At least one year since prior daily alcohol use
• At least one year since prior cigarette use
• Must have supportive live-in spouse or other family member

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• No prior chemotherapy
• No other concurrent chemotherapy

Endocrine therapy:

• No concurrent hormonal therapy except:

  • Steroids for antiemesis, documented CNS metastases, adrenal failure, or septic shock
  • Hormonal therapy for nondisease related conditions (e.g., thyroid replacement therapy)

Radiotherapy:

• No prior radiotherapy
• Concurrent palliative radiotherapy allowed, including to a symptomatic lesion or one which may produce disability (e.g., unstable femur or CNS lesion)

Surgery:

• Greater than 1 week since prior exploratory or palliative bypass surgery
• No prior Whipple procedure or surgical procedure for curative intent

Other:

• No oral hypoglycemic agents