Dalteparin for Primary Venous Thromboembolism (VTE) Prophylaxis in Pancreatic Cancer Patients

Inclusion Criteria

• Patients with the diagnosis of advanced stage (unresectable or metastatic) adenocarinoma of the pancreas. Patients with borderline resectable will also be eligible if they are starting chemotherapy and/or chemo/radiation therapy (RT) prior to attempting resection.
• Patients must be planning to initiate systemic chemotherapy within 2 weeks. Chemotherapy that is being given concurrently with radiation is allowed.
• Age >/= 18 years old
• Adequate renal function defined as a calculated creatinine clearance of > 50 mL/min (as reported by the MDACC laboratory using MDRD method or using Cockroft and Gault formula).
• Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2.
• Negative urine or serum pregnancy test in women with childbearing potential, within one week prior to initiation of treatment.
• Patients must sign an Informed Consent.
• Patient must agree to transfusion of blood products, when indicated.
• Ability to administer subcutaneous injections of the study drug by the patient and/or care giver.

Exclusion Criteria

• Patients with evidence of venous thrombosis on the initial lower extremity screening ultrasound or incidental VTE of other sites (e.g. PE, Abdominal/pelvic vein thrombosis, etc.).
• Patients already taking prophylactic or full dose anticoagulation (eg. heparin, low-molecular weight heparin, fondaparinux, or coumadin).
• Patients with currently active bleeding.
• The presence of a condition with a high risk for bleeding, including but not limited to active peptic ulcer, recent neurosurgery, or cirrhosis with esophageal varices.
• Patients with known brain metastases.
• Patients with a known bleeding diathesis.
• Patients with a platelet count /= 325 mg of aspirin daily, or daily clopidogrel, or daily non-steroidal antiinflammatory medications (eg., ibuprofen, naproxen).