Aim-The aim of this study was to determine the safety and the efficacy of a gemcitabine/oxaliplatin combination (GEMOX) as first line therapy in patients with metastatic or unresectable locally-advanced pancreatic cancer. Patients and methods-Patients received gemcitabine 1000 mg/m2 as a 10 mg/m2/min infusion on day 1 followed on day 2 by oxaliplatin 100 mg/m2 as a 2 hour infusion, each cycle being given every 2 weeks. All patients had measurable disease and histological diagnosis before inclusion. Patients were treated until progression or for 12 cycles in the absence of progression. Tumor lesions were assessed by computed tomography scan every 4 cycles. Results-Between January 2001 and January 2003, 32 patients were eligible for the study. The objective response rate (OR) was 28.1%with a 12.5%complete response rate (CR). Median progression-free survival and median overall survival were 7 and 9 months, respectively. Median overall survival for patients with metastatic disease and locally-advanced disease were 7 and 25 months, respectively (P < 0.0007). Eleven patients were alive at 1 year (34.4%), six at 2 years (18.8%) and two at 3 years (6%). Fourteen (43.8%) of 32 patients experienced a clinical benefit response. Conclusion-These results support the safety, the antitumor activity and the possibility of durable responses of the GEMOX regimen in patientswith locally-advanced disease. Aim-The aim of this study was to determine the safety and the efficacy of a gemcitabine / oxaliplatin combination (GEMOX) as first line therapy in patients with metastatic or unresectable locally-advanced pancreatic cancer. Patients and methods-Patients received gemcitabine 1000 mg / m2 as a 10 mg / m2 / min infusion on day 1 followed on day 2 by oxaliplatin 100 mg / m2 as a 2 hour infusion, each cycle was given every 2 weeks. All patients had measurable disease and histological diagnosis before inclusion. Patients were treated until progression or for 12 cycles in the absence of progression. Tumor lesions were assessed by computed tomography scan every 4 cycles. Results-Between January 2001 and January 2003, 32 patients were eligible for the study. The objective response rate (OR) was 28.1% with a 12.5% ​​complete response rate (CR). Median progression-free survival and median overall survival were 7 and 9 months, respectively. Median overall survival for patients with metastatic disease and loca Eleven patients were alive at 1 year (34.4%), six at 2 years (18.8%) and two at 3 years (6%). Fourteen (43.8 %) of 32 patients experienced a clinical benefit response. Conclusion-These results support the safety, the antitumor activity and the possibility of durable responses of the GEMOX regimen in patients with locally-advanced disease.