Advanced-stage surgically unresectable adenocarcinoma of the pancreas is highly lethal. Attempts to improve this survival with chemotherapy were dismal, until gemcitabin was shown to be clinically beneficial and to modestly improve survival. We started an open multicentric compassionate study of gemcitabine in advanced adenocarcinoma of the pancreas to assess those benefits. Of 74 patients who were enrolled, 46 were assessable for tumoral response (2 partial response, 18 stable disease, 24 progressing disease). A clinical benefit was obtained in 48% of assessable patients. Myelotoxicity, nausea and vomiting were the major side effect. The median event-free and overall survivals from study inclusion were 2. 5 and 5 months respectively. This study confirms that gemcitabine can be effective even in patients with pretreated advanced adenocarcinoma of the pancreas.