S0727 Gemcitabine Hydrochloride and Erlotinib Hydrochloride With or Without Monoclonal Antibody Therapy in Treating Patients With Metastatic Pancreatic Cancer That Cannot Be Removed By Surgery

Inclusion Criteria: * Histologically or cytologically confirmed pancreatic adenocarcinoma * Stage IV disease (any T, any N, M1 \[distant metastases\]) * Unresectable disease * Histologic diagnosis based on a metastatic site must be compatible with pancreatic cancer * Measurable and/or nonmeasurable disease * No endocrine or neuroendocrine tumors, lymphoma of the pancreas, or ampullary cancer * No macroscopic residual disease post-resection as the only site of disease * No clinically significant ascites * No known brain metastases * Patients with neurologic signs or symptoms must undergo brain imaging studies AND studies must be negative for disease * Zubrod performance status 0-1 * ANC ≥ 1,500/mcL * Platelet count ≥ 100,000/mcL * Hemoglobin ≥ 9 g/dL * Leukocytes ≥ 3,000/mcL * Total bilirubin normal * SGOT or SGPT ≤ 2.5 times upper limit of normal (ULN) * Serum creatinine ≤ 1.5 times ULN OR creatinine clearance ≥ 60 mL/min * Fasting serum glucose \< 120 mg/dL or below the ULN * Patients with diabetes mellitus who meet this criterion must be on a stable dietary or therapeutic regimen for this condition * INR ≤ 1.5 and PTT ≤ 5 seconds above ULN * Not pregnant or nursing * Fertile patients must use effective contraception * Willing to submit previously collected tumor tissue specimens * No history of allergic reaction attributed to compounds of similar chemical or biological composition to anti-IGF-1R recombinant monoclonal antibody IMC-A12 * No active acute or chronic infections requiring antibiotics * No significant ongoing cardiac problems, including any of the following: * Myocardial infarction within the past 6 months * Uncontrolled hypertension * Unstable angina * Uncontrolled arrhythmia * Congestive heart failure * No known HIV infection * No other prior malignancy, except for the following: * Adequately treated basal cell or squamous cell skin cancer * Carcinoma in situ of the cervix * Adequately treated stage I or II cancer from which the patient is currently in complete remission * Any other cancer from which the patient has been disease-free for 5 years * At least 14 days since prior surgery * At least 28 days since prior radiotherapy for palliation to metastatic sites * Patient must have other untreated metastatic sites that would qualify them for this protocol * At least 6 months since prior adjuvant chemotherapy * No prior chemotherapy, hormonal therapy, immunotherapy, or chemoradiotherapy for advanced or locally advanced pancreatic cancer, including drugs that target either EGFR or IGFR * No plans to receive concurrent chemotherapy, hormonal therapy, radiotherapy, immunotherapy, or any other type of therapy for treatment of cancer * No prior gemcitabine hydrochloride * No prior chimerized or murine monoclonal antibody therapy * No concurrent CYP3A4 inducers including, but not limited to, any of the following: * Rifampicin * Rifabutin * Rifapentine * Phenytoin * Carbamazepine * Phenobarbital * Hypericum perforatum (St. John's wort) * No concurrent CYP3A4 inhibitors including, but not limited to, any of the following: * Atazanavir * Clarithromycin * Indinavir * Itraconazole * Ketoconazole * Nefazodone * Nelfinavir * Ritonavir * Saquinavir * Telithromycin * Troleandomycin * Voriconazole * Concurrent prophylactic low-dose coumadin or low molecular weight heparin allowed provided coagulation criteria are met * Full-dose anticoagulation allowed provided coagulation criteria are met and are under strict control and monitoring