Immunochemoradiotherapy in Patients With Pancreatic Cancer

Exclusion Criteria

• •Age \< 18 years
• •History of other malignancy in the past 2 years except carcinoma in situ of the cervix or bladder, or non-melanomatous skin cancer
• •Previous chemotherapy or radiation therapy for pancreatic cancer or previous radiation therapy to the target field
• •Clinically active autoimmune disease or active infection
• •History of heart attack (within 90 days) or stroke (within 6 months), or presence of hypertension requiring change in blood pressure medications in the last 4 weeks, hypotension, uncontrolled arrhythmias, heart failure (New York Heart Association (NYHA) Functional Classification ≥ Class 2 in last 6 months), unstable angina or angina occurring during sexual activity.
• •Use of "nitrates" or nitroglycerin.
• •History of hereditary degenerative retinal disorders including retinitis pigmentosa.
• •Chronic systemic corticosteroid use at supra-physiologic doses (prednisone \> 10 mg a day or equivalent)
• •Use of recreational drugs called "poppers" like amyl nitrite and butyl nitrite.
• •Laboratory values (performed within 14 days prior to enrollment) as follows:
• •* Neutrophil count \< 1500 cells/µL
• •* Hemoglobin \< 9 gm/dL (patients may be transfused to establish eligibility)
• •* Platelet count \< 100,000 cells/µL
• •* Significant coagulopathy (INR \> 1.5)
• •* Significant liver or renal dysfunction
• •Other medical or psychiatric conditions that in the opinion of the Principal Investigator would preclude safe participation in protocol.