• Histological or pathological confirmation of metastatic pancreas adenocarcinoma

∙ Cytologic or histologic proof of pancreas adenocarcinoma needs to be verified by the treating institution pathologist, either from the initial diagnostic biopsy or from the required pre-treatment biopsy, prior to initiation of any study-related therapy.

‣ Pathologic confirmation of metastatic (stage IV) disease (unresectable) on research pretreatment biopsy is required prior to initiation of therapy.

‣ Patients with endocrine or acinar pancreatic carcinoma are not eligible for the study.

• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

• Age ≥18 years

• Adequate hematological and end-organ function (test results from within 14 days prior to initiation of study treatment):

∙ Absolute Neutrophil Count (ANC) ≥ 1.5 x 109/L without granulocyte colony-stimulating factor support

‣ White Blood Cell Count (WBC) count ≥ 2.5 x 109 /L (2500/uL)

‣ Lymphocyte count ≥ 0.5 x 109/L (500/uL)

‣ Platelet count ≥ 100 x 109/L (100,000/uL) without transfusion

‣ Hgb ≥ 9.0 g/dL

‣ Aspartate aminotransferase (AST), alanine transaminase (ALT), and alkaline phosphatase (ALP) ≤ 2.5X upper limit of normal (ULN), unless elevated secondary to biliary obstruction from the pancreas mass and amenable to decompression prior to initiation of therapy

‣ Serum total bilirubin ≤ 1.5X ULN, unless in patients with known Gilbert disease (≤ 3X ULN), or unless elevated secondary to biliary obstruction from the pancreas mass and amenable to decompression prior to administration of investigational therapy

‣ Albumin ≥ 3.5 g/dL

‣ Creatinine within ULN or calculated creatinine clearance (CrCl) \>50 mL/min using the Cockcroft-Gault formula

∙ International normalized ratio (INR) and activated partial thromboplastin time (aPTT) ≤ 1.5X ULN, except for those on stable anticoagulation for at least two weeks

• Measurable disease according to Immune Modified (IM)-RECIST and tumor accessible for fresh biopsy

• Negative pregnancy test: Women of child-bearing potential must have a negative serum pregnancy test at screening and must agree to use an effective form of contraception from the time of the negative pregnancy test until a minimum of 3 months after the last dose of study drug. Effective forms of contraception include abstinence, hormonal contraceptive (injectable or implantable) in conjunction with a barrier method. Women of non-child-bearing potential must have been postmenopausal for ≥ 1 year or surgically sterile.

• Birth control agreement: Fertile men must agree to use an effective method of birth control with female partners of childbearing potential (condoms plus an additional contraceptive method such as an injectable or implantable hormonal contraceptive) during the study and for up to 3 months after the last dose of study drug.

• Informed consent: Participants must be willing and able to provide written informed consent prior to any study-related procedures and to comply with all study requirements.

• Ability to comply: Participants must be able to comply with the study protocol, according to the investigator's judgement.

⁃ DVT testing Participants must have undergone lower extremity dopplers to rule out deep venous thrombosis (DVT) within the screening period, and undergo therapeutic anticoagulation if evidence of DVT is identified.

⁃ Anticoagulation treatment Subjects who are stable on full-dose anticoagulation medication for at least 2 weeks are considered eligible. However, subjects who have an increased clot burden on full-dose anticoagulation, such as central pulmonary embolism, or peripheral pulmonary embolism, and DVT within the extremities will be considered eligible only with the approval of the Principal Investigator.