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Pancreatic cancer is the fourth most common cause of cancer-related death in the U.S., with the case fatality rate nearly the same as the incidence rate. Palliative chemotherapy with single-agent gemcitabine (Gemzar) is the standard of care. However, the efficacy of gemcitabine is modest: low rate of antitumor response, median survival of 5 to 6 months, and 1-year survival of 17% to 18%. Phase III trials, in which a second chemotherapy agent (5-fluorouracil, irinotecan, platinum-containing drugs, and, more recently, targeted agents such as bevacizumab and cetuximab) was combined with gemcitabine, have failed to demonstrate better rates of either response or survival, compared with gemcitabine alone. Because overexpression of epidermal growt…