
    slow accrual
  
['stage ia pancreatic cancer', 'stage ib pancreatic cancer', 'stage iia pancreatic cancer', 'stage iib pancreatic cancer']
['metformin hydrochloride']

        Inclusion Criteria:

          -  Patients must have histologically or cytologically confirmed resectable pancreatic
             carcinoma; patients with pancreatic neuroendocrine tumors are not eligible

          -  Patients must be previously untreated with chemotherapy or radiation therapy

          -  Eastern Cooperative Oncology Group (ECOG) performance status =< 2

          -  Patients must have surgical resection of the pancreas planned, with enrollment at
             least 7 days prior to surgery; patients with surgery scheduled > 15 days will not be
             excluded

          -  Hemoglobin (Hg)A1C must be below 7%

          -  Total bilirubin less than 1.5 X institutional upper limit of normal

          -  Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) =<
             2.5 X institutional upper limit of normal

          -  Alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 X
             institutional upper limit of normal

          -  Serum creatinine within normal institutional limits

          -  Alkaline phosphatase < 1.5 X institutional upper limit of normal

          -  Subjects must have the ability to understand and be willing to provide written
             informed consent

        Exclusion Criteria:

          -  History of metformin use in the previous 3 months

          -  Treatment with neoadjuvant chemotherapy or radiation therapy

          -  History of allergic reactions attributed to metformin

          -  Patients with uncontrolled intercurrent illness including, but not limited to ongoing
             or active infection, symptomatic congestive heart failure, unstable angina pectoris,
             cardiac arrhythmia, or psychiatric illness/social situations that would limit
             compliance with study requirements

          -  Metabolic acidosis, acute or chronic, including ketoacidosis

          -  Metastatic disease
      