15515 Background: Clinical trials evaluating combination therapy for pancreatic cancer have been disappointing. The addition of E to G has resulted in a modest, yet statistically significant improvement in progression-free, overall, and 1-year survival, without an improvement in response rate, while the addition of B to G, has failed to prove beneficial. In an attempt to capitalize on the lack of overlapping toxicities and potential enhancement of activity of epidermal growth factor receptor inhibitors as demonstrated in colorectal cancer, we initiated this study to determine the safety and efficacy of adding B to G and E. Methods: Thirty patients (pts) with LAPC or MPC who had adequate hepatic, renal and hematopoietic function, and ECOG performance status of 0–1, were registered. Treatment consisted of G 1,000 mg/m2 intravenously (IV) on days 1, 8, and 15, E 100 mg orally days 1–28, and B 10 mg/kg IV days 1 and 15, every 28 days. Tumor measurements were performed every 8 weeks. Pts were assessed for radiologic response (RECIST), time to tumor progression (TTP), median overall survival (MS), 1-year survival, and toxicity (TOX). Results: Twenty-eight pts began study therapy. Two pts never began study therapy: 1 pt withdrew consent and another experienced a massive pulmonary embolus (PE) prior to treatment. In addition, 1 pt experienced an upper GI bleed and did not complete 1 cycle and 1 pt did not have restaging scans. Of the 28 treated pts, 3 had LAPC and 25 had MPC. Response data is available on 23 pts. There were 5 (22%) partial responses, 4 (17%) confirmed partial responses, 13 (57%) with stable disease, and 6 (26%) with progressive disease. The median TTP was 3.5 (95%CI 2.6–5.2) months. The MS was 6.8 (95%CI 5.3-not estimatable) months. Grade 3–4 treatment-related TOX included: 6 (27%) neutropenia, 2 (7.7%) SGOT, 2 (7.7%) SGPT, 3 (11.5%) fatigue, 2 (7.7%) acneform rash, 1 (3.8%) duodenal hemorrhage, 1 (3.8%) PE and 1 (3.8%) arterial event. Conclusions: The combination of G, E and B was well tolerated, and shows modest activity in pts with locally advanced and metastatic pancreatic cancer. Supported by Genentech. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Genentech™ BioOncology