['adenocarcinoma of the pancreas']
['mk-1775', 'gemcitabine']

        Inclusion Criteria:

          -  Patients must have pathologically confirmed adenocarcinoma of the pancreas.

          -  Patients will have unresectable disease, defined radiographically as >180 degrees
             involvement of the superior mesenteric artery or celiac trunk or SMV/portal vein
             impingement that cannot be surgically reconstructed, in the absence of distant
             metastasis..

          -  Patients must have a Zubrod performance status (measure of general well being that
             ranges from 0 to 5 where 0 represents perfect health) of < 2.

          -  Patients must have adequate organ function defined as follows: absolute neutrophil
             count of ≥ 1500/mm3, platelets ≥ 100,000/mm3, serum creatinine ≤ 2 mg/dl, total
             bilirubin ≤ 3, (with relief of biliary obstruction if present (PTC tube or endobiliary
             stent)) and AST < 5 times the upper limit of normal.

          -  Patients of reproductive potential must agree to use an effective contraceptive method
             during participation in this trial and for 6 months after the trial. Patients must not
             be breastfeeding.

          -  Patients must be aware of the investigational nature of the therapy and provide
             written informed consent.

          -  Patients must be at least 18 years old.

        Exclusion Criteria:

          -  Other serious uncontrolled concomitant systemic disorders or psychiatric condition
             that would interfere with the safe delivery of protocol therapy.

          -  A history of previous chemotherapy for pancreatic cancer or abdominal radiation
             therapy.

          -  The use of any investigational agent in the month before enrollment into the study.

          -  Inability to discontinue a prescription or non-prescription drugs or other products
             known to be metabolized by CYP3A4, or to inhibit or induce CYP3A4 prior to Day 1 of
             dosing and to withhold throughout the study until 2 weeks after the last dose of study
             medication. Medications of particular concern are the following inhibitors of CYP3A4:
             azole antifungals (ketoconazole itraconazole, fluconazole and voriconazole), macrolide
             antibiotics (erythromycin, clarithromycin), cimetidine, aprepitant, HIV protease
             inhibitors, nefazodone and the following inducers of CYP3A4: phenytoin, barbiturates
             and rifampicin. Substrates of CYP3A4 include statins (lovastatin, simvastatin),
             midazolam, terfenadine, astemizole, and cisapride.
      