Panitumumab, Chemotherapy, and External-Beam Radiation Therapy in Treating Patients With Locally Advanced Pancreatic Cancer That Cannot be Removed by Surgery

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed unresectable adenocarcinoma of the pancreas

  • Including subtotal resection and gross residual disease

    • No microscopic residual disease only
• Measurable disease is not required
• Disease is encompassable within standard radiotherapy fields for pancreatic cancer
• No evidence of metastatic disease outside of the planned radiotherapy field
• No cystadenocarcinoma of the pancreas or pancreatic tumors of neuroendocrine origin
• No distant metastases (i.e., liver or lung metastases or peritoneal spread)
• No history or known presence of CNS metastases

PATIENT CHARACTERISTICS:

• ECOG performance status 0-1
• ANC ≥ 1,500/mm³
• Hemoglobin ≥ 9.0 g/dL
• Platelet count ≥ 100,000/mm³
• Total bilirubin ≤ 3 times upper limit of normal (ULN)* NOTE: *Biliary stent placement or surgical bypass should be considered prior to treatment if impending bile duct obstruction by tumor
• AST ≤ 3 times ULN
• Creatinine ≤ 2.0 times ULN
• Magnesium normal
• Willing to return to an NCCTG institution for follow-up
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for at least 6 months after treatment with panitumumab
• No prior or concurrent malignancy unless disease-free ≥ 3 years except for non-melanoma skin cancer, carcinoma in situ of the cervix, or organ confined prostate cancer with Gleason score < 7
• No nausea or vomiting > grade 1

• No uncontrolled intercurrent illness including, but not limited to, any the following:

  • Ongoing or active infection
  • Psychiatric illness or social situations that would limit compliance with study requirements

• No New York Heart Association clinically significant cardiovascular disease ≥ grade 2, including any of the following within the past year:

  • Myocardial infarction
  • Unstable angina
  • Symptomatic congestive heart failure
  • Serious, uncontrolled cardiac arrhythmia
• No known HIV positivity
• No known hepatitis C virus or acute or chronic active hepatitis B infection
• Adequate oral nutrition

PRIOR CONCURRENT THERAPY:

• More than 21 days since prior laparotomy
• No prior anti-epidermal growth factor receptor (EGFR) antibody therapy (e.g., cetuximab)
• No prior small molecule EGFR inhibitors (e.g., gefitinib, erlotinib, or lapatinib)
• No prior radiotherapy that would overlap with planned radiotherapy fields
• No prior or other concurrent chemotherapy
• No prior or other concurrent biologic therapy
• More than 4 weeks since prior and no concurrent or planned participation in another experimental drug study except studies with specific interventions intended to treat rashes associated with EGFR agents (e.g., N05C4)
• No concurrent enteral hyperalimentation
• No concurrent chronic immunosuppressive agents (e.g., methotrexate, cyclosporine, or corticosteroids)
• No concurrent colony-stimulating factors during the first course of therapy
• No other concurrent immunotherapy or radiotherapy