Trial of Pemetrexed for Patients With Pancreatic Cancer Which Cannot be Treated With Surgery or is Metastatic

Inclusion Criteria: * Histological or cytological diagnosis of adenocarcinoma of the pancreas that is locally advanced (Stage II, III) or metastatic (Stage IV), as staged by the American Joint Committee on Cancer (AJCC; Protocol Attachment S041.2; Fleming et al. 1997), and not amenable to resection with curative intent. * Prior systemic first line chemotherapy with gemcitabine single agent or a combination regimen including gemcitabine (not more than one prior systemic chemotherapy allowed). * Uni-dimensionally measurable disease according to the RECIST criteria (Therasse et al. 2000), defined as: At least one lesion that can be accurately measured in at least one dimension, with the longest diameter greater than or equal to 2 cm with conventional techniques or greater than or equal to 1.0 cm with spiral CT scans. Ultrasound and X-ray are NOT allowed to measure or follow lesions. Exclusion Criteria: * Prior radiation of equal to or greater than 25% of the bone marrow (Cristy and Eckerman 1987) * Prior immunotherapy, biological therapy, and/or hormonal therapy for pancreas cancer. * Prior systemic chemotherapy with 5-FU. * Patient not yet recovered from the acute toxic effects of the treatment prior to study enrollment. * Radiotherapy within the last 4 weeks before study entry