Intervention: Alovudine
Trial phase: Phase 2
SMILES: Cc1cn([C@H]2C[C@H](F)[C@@H](CO)O2)c(=O)[nH]c1=O
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 6
Group description: The experimental 18F-FLT-PET/CT is required to be completed before initiation of chemotherapy. Labs and correlative radiology, as directed per clinical care, are required within 30 days prior to 18F-FLT-PET/CT; and 18F-FDG-PET/CT is required within 30 days before the 18F-FLT-PET/CT. Follow-up will comprise 24 months of standard practice treatment and follow up.

Procedure: Computed Tomography
Drug: 3'-deoxy-3'-[F-18] fluorothymidine: [F-18]FLT
Other: Laboratory Biomarker Analysis

Procedure: Positron Emission Tomography

3'-deoxy-3'-[F-18] fluorothymidine: [F-18]FLT: Given IV The experimental 18F-FLT-PET/CT is required to be completed before initiation of chemotherapy. Labs and correlative radiology, as directed per clinical care, are required within 30 days prior to 18F-FLT-PET/CT; and 18F-FDG-PET/CT is required within 30 days before the 18F-FLT-PET/CT. Follow-up will comprise 24 months of standard practice treatment and follow up.

Computed Tomography: Undergo PET/CT

Positron Emission Tomography: Undergo PET/CT

Laboratory Biomarker Analysis: Correlative studies
Eligibility criteria:
Inclusion Criteria:

Patients with histologically confirmed pancreatic adenocarcinoma (resectable, borderline resectable or locally advanced disease at presentation) are eligible for the study.
Patients should not have any type of curative or palliative therapy for pancreatic adenocarcinoma before enrolling in the study.
Patients must be over 18 years old and capable and willing to provide informed consent.
Patients must have measurable disease (by RECIST 1.1 criteria)
Patients must have an ECOG performance status of 0-3 (restricted to ECOG PS 0-2 if age >70 years).
Patients of childbearing potential must have a negative urine or serum pregnancy test within 7 days prior to FLT (or FDG if for research) PET/CT imaging per institution's standard of care; A female of child-bearing potential is any woman (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria; Has not undergone a hysterectomy or bilateral oophorectomy; or Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months).
Medically stable as judged by patient's physician.
Patients with known allergic or hypersensitivity reactions to previously administered radiopharmaceuticals of similar chemical or biologic composition to FLT are NOT eligible.
Ability to understand and the willingness to sign a written informed consent.
Patient must be able to lie still for a 20 to 30 minute PET/CT scan.

Exclusion Criteria:

Subjects who had prior chemotherapy or radiotherapy for pancreatic adenocarcinoma cannot participate in the study.
Patient must NOT be pregnant or breast-feeding.
Patients have no clinical evidence of distant metastatic disease
Patients must not weigh more than the maximum weight limit for the table for the PET/CT scanner where the study is being performed.(>200kg or 440lbs)