Study of Pemetrexed for Second-Line Pancreas Cancer

Inclusion Criteria:

• Histologically confirmed adenocarcinoma of the pancreas
• Prior treatment for distant or locally advanced disease with gemcitabine-based therapy
• Measurable or evaluable disease
• ECOG performance status 0-2
• Adequate hematological parameters
• Adequate baseline liver function
• At least 28 days from any major surgery
• At least 2 weeks from the last radiation treatment
• Must have recovered from reversible toxicities of prior chemotherapy
• Must be able to discontinue any nonsteroidal anti-inflammatory medications
• Must be willing to receive intramuscular vitamin B12 shots and take oral folate supplements

Exclusion Criteria:

• Any prior treatment with pemetrexed
• More than one prior chemotherapy regimen
• HIV positive on antiretroviral therapy
• Pregnant or lactating
• Prior organ allograft
• On concurrent antitumor therapy including radiation therapy or other chemotherapies
• Creatinine clearance 45 ml/min or less
• Absolute neutrophil count < 1500
• Platelets < 75,000
• Bilirubin > 1.5 times the upper limit of normal
• Transaminases > 3 times the upper limit of normal except in known liver metastasis wherein they may be </= 5 times upper limit of normal
• Clinically significant ascites or pleural effusion that cannot be drained
• Any medical or psychiatric condition that may interfere with the ability to comply with protocol treatment