Gemcitabine Versus Reduced-dose Combination Chemotherapy in Fragile Patients with Non-resectable Pancreatic Cancer

This study compares two chemotherapy approaches for people with pancreatic cancer that cannot be surgically removed and who are not well enough to tolerate standard full-dose combination chemotherapy. It compares single-agent gemcitabine (a milder option) against a lower-dose combination chemotherapy regimen. **You may be eligible if...** - You are 18 or older with confirmed pancreatic adenocarcinoma - Your cancer is locally advanced or has spread (metastatic) and cannot be surgically removed - You are not a candidate for full-dose combination chemotherapy - Your overall health and organ function allow for chemotherapy - You have not yet received chemotherapy for your pancreatic cancer **You may NOT be eligible if...** - You have already received chemotherapy for pancreatic cancer - Your organ function (kidneys, liver, bone marrow) is too impaired to safely receive any chemotherapy - You have serious uncontrolled infections or other medical problems Talk to your doctor to see if this trial is right for you.