Combining Erlotinib Plus Bevacizumab and Gemcitabine Plus Capecitabine to Treat Advanced Pancreatic Cancer

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically or cytologically confirmed adenocarcinoma of the pancreas * Locally advanced or metastatic disease * Not amenable to curative resection * No invasion of adjacent organs (e.g., duodenum or stomach) by CT scan * Unidimensionally measurable disease as assessed by CT in accordance with the Response Evaluation Criteria in Solid Tumors (RECIST) guidelines. * No evidence of brain metastasis PATIENT CHARACTERISTICS: Age: * 18 and over Performance status: * Eastern Cooperative Oncology Group (ECOG) 0-2 Life expectancy: * Greater than 3 months Hematopoietic: * Granulocyte count ≥ 1,500/mm\^3 * Platelet count ≥ 100,000/mm\^3 Hepatic: * Bilirubin ≤ upper limit of normal * Serum albumin \> 26 g/litre Renal: * Creatinine ≤ 180 micromoles/litre OR * Creatinine clearance ≥ 50 mL/min Cardiovascular: * No clinically significant cardiovascular disease * No uncontrolled hypertension (i.e., blood pressure \> 150/90 mm Hg on medication) * No arterial thromboembolic event within the past 6 months, including any of the following: * Myocardial infarction * Unstable angina pectoris * Cerebrovascular accident * Transient ischemic attack * No New York Heart Association grade II-IV congestive heart failure * No serious cardiac arrhythmia requiring medication OTHER: * Not pregnant or breast feeding * Fertile patients must use effective contraception during study participation * No serious or non-healing wound, ulcer, or bone fracture * No infection requiring parenteral antibiotics * No major bleeding diathesis or coagulopathy * No significant traumatic injury within the past 28 days * No surgery within the last 28 days or anticipation for the need for major surgery during the course of study treatment * No other active malignancy except non-melanoma skin cancer and cervical cancer in-situ * No history of known dihydropyrimidine dehydrogenase (DPD) deficiency * No lack of physical integrity of the upper gastro-intestinal tract, malabsorption syndrome, or inability to take oral medication PRIOR CONCURRENT THERAPY: * No previous chemotherapy, radiotherapy or other investigational drug treatment for metastatic disease (including VEGF or EGFR antagonists) * No previous preoperative or adjuvant chemotherapy, radiotherapy or other investigational drug treatment. * No full dose anti-coagulation (i.e. warfarin or full dose low molecular weight heparin) prior to starting study treatment. * No ongoing treatment with aspirin (\>325 mg/day) or other medications known to predispose to gastrointestinal ulceration