
    recruitment problem
  
['locally advanced pancreatic cancer', 'adenocarcinoma, pancreas', 'metastatic pancreatic cancer']
['clopidogrel', 'placebo']

        Inclusion Criteria:

          -  18 years of age or older

          -  Histologically or cytologically confirmed adenocarcinoma of the pancreas

          -  Locally advanced or metastatic pancreatic cancer

          -  Measurable primary pancreatic cancer or metastasis

          -  No previous chemotherapy either in an adjuvant or metastatic setting

          -  Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1

          -  Adequate bone marrow: granulocyte count ≥ 1.5 G/L; and platelet count ≥ 100 G/L

          -  Adequate liver function: bilirubin ≤ 2 times the upper limit of the normal range,
             transaminases (AST and ALT) ≤ 3 times the upper limit of the normal range

          -  Adequate renal function: calculated clearance rate > 60 m.mn-1 (Estimated glomerular
             filtration rate using Modification of Diet in Renal Disease (MDRD) formula or
             Cockcroft-Gault formula)

          -  Women of childbearing potential must use an effective birth control method

        Exclusion Criteria:

          -  Endocrine or acinar pancreatic carcinoma

          -  Pancreatic metastasis of other primary tumors

          -  Previous radiotherapy for measurable lesions

          -  Previous chemotherapy

          -  History of brain metastases, uncontrolled spinal cord compression, or carcinomatous
             meningitis

          -  Other prior malignancy. Adequately treated basal cell or squamous cell skin cancer,
             carcinoma in situ of the cervix or any other cancer from which the patient has been
             disease free for > 5 years are allowed.

          -  Known HIV disease requiring antiretroviral treatment

          -  Hemorrhagic diathesis

          -  Aspirin with a daily dose > 75 mg

          -  Curative dose of LMWH

          -  Recent venous thromboembolism (< 1 year)

          -  Patients under VKA

          -  Lesion of the digestive tract that could be hemorrhagic with clopidogrel treatment

          -  Active infection

          -  Chronic diarrhea

          -  Cardiac disease with a left ventricular ejection fraction below 45%

          -  Hypersensitivity to clopidogrel or its excipients

          -  Patients with severe hepatic impairment

          -  Patients who are pregnant or breast feeding, or who are not using effective birth
             control methods

          -  Participation in another clinical research protocol, participation in a trial of
             routine care is authorized at the same time as PANCREADOGREL

          -  Patient under tutorship or curatorship

          -  Patients unwilling or unable to comply with the protocol

          -  Not affiliated to health system ("bénéficiaire ou ayant droit")
      