Second Line Chemotherapy for Advanced Pancreatic Cancer

Inclusion Criteria: * Signed written informed consent prior to beginning protocol specific procedures * Previous chemotherapy with Gemcitabine plus or less Platinoids * Previous gemcitabine delivered as a radiosensitizer for locally advanced disease, followed or not by a gemcitabine plus or less platinoids as maintenance or disease progression is allowed. * Male or female less than 75 years of age * Diagnosis of histologically or cytologically confirmed adenocarcinoma of the pancreas * Locally advanced (non-resectable) or metastatic pancreatic cancer * Presence of at least one uni-dimensional indicator lesion measurable by CT scan or MRI in not an irradiated area * ECOG performance status 0 to 1 at study entry * Life expectancy: more than 3 months * Neutrophils more than 1.5 x 109L, platelets more than 100 x 109L, and hemoglobin more than 10 gdL * Bilirubin level either normal or less than 1.5 x ULN * ASAT and ALAT normal or less than 2.5 x ULN (normal or less than 5 x ULN if liver metastasis are present) * Serum creatinine less than 1.5 x ULN * Amylase normal or less than 1.5 ULN * Effective contraception for both male and female patients if the risk of conception exists * Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be assessed with the patient before registration in the trial Exclusion Criteria: * Brain metastases * Previous treatment with irinotecan or fluoropyrimidines * Significant cardiovascular disease: clinically relevant coronary artery disease or a history of a myocardial infarction within the last 6 months * Significant gastrointestinal abnormalities * Gilbert's Syndrome * Any uncontrolled infections * Known HIV infection * Radiotherapy within 4 weeks prior to study entry * Any investigational agents 4 weeks prior to entry * Known grade 3 or 4 allergic reaction to any of the components of the treatment * Known drug abuse or alcohol abuse * Medical or psychological condition which in the opinion of the investigator would not permit the patient to complete the study or sign meaningful informed consent * Women who are pregnant or breastfeeding * Any concurrent malignancy other than non-melanoma skin cancer, or carcinoma in situ of the cervix. * Legal incapacity or limited legal capacity