Nab-paclitaxel and Gemcitabine, in Elderly Patients Untreated Metastatic Pancreatic Adenocarcinoma

Inclusion Criteria: * Histologically or cytologically-confirmed pancreatic adenocarcinoma * Stage IV disease (metastatic only) * No prior systemic therapy for their diagnosis (except in adjuvant setting \> six months previously) * ECOG performance status of 0-1 * Age \>=70 years. * Evidence of either or both of the following: * RECIST-defined measurable disease (lesions that can be accurately measured in at least one dimension with the longest diameter \>= 20mm using conventional techniques or \>= 10 mm with spiral CT scan) * An elevated serum CA19-9 at baseline ( \>= 2X ULN) * Female patients must be either surgically sterile or postmenopausal. * Male patients must be surgically sterile or must agree to use a condom during sex with women who may become pregnant while receiving the study drug and for 6 months after receiving the last dose. * Adequate bone marrow function: * ANC \>= 1500/uL * platelet count \>= 100,000/uL * hemoglobin \>= 9.0 g/dL * Adequate hepatic function: * Total bilirubin \<= 1.5 X ULN * AST (SGOT) \<= 2.5 X ULN * ALT (SGPT) \<= 2.5 X ULN * Adequate renal function as determined by either: * Serum creatinine \<= 1.5 X ULN * Calculated or measured creatinine clearance \>= 40 mL/min (for calculated creatinine clearance, Cockroft-Gault equation will be used). * Ability to understand the nature of this study protocol and give written informed consent * Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures. Exclusion Criteria: * Any prior systemic or investigational therapy for metastatic pancreatic cancer. * Inability to comply with study and/or follow-up procedures. * History of other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that, in the opinion of the investigator, renders the subject at high risk from treatment complications or might affect the interpretation of the results of the study. * Presence of central nervous system or brain metastases. * Life expectancy \< 12 weeks. * Pregnancy (positive pregnancy test) or lactation. * Prior malignancy except for adequately treated basal cell skin cancer, in situ cervical cancer, adequately treated Stage I or II cancer from which the patient is currently in complete remission, or any other form of cancer from which the patient has been disease-free for 5 years. * Clinically significant cardiac disease (e.g. congestive heart failure, symptomatic coronary artery disease and cardiac arrhythmias not well controlled with medication) or myocardial infarction within the last 12 months. * Lack of physical integrity of the upper gastrointestinal tract or malabsorption syndrome. * Known, existing uncontrolled coagulopathy. * Pre-existing sensory neuropathy \> grade 1. * Major surgery within 4 weeks of the start of study treatment, without complete recovery. * Concurrent/pre-existing use of anticoagulant treatment.