Patient description: The patient is a 41-year-old obese woman coming to the emergency room with abdominal pain and vomiting. The pain that started gradually yesterday is located in the epigastric and periumbilical regions, radiating to her back. She drinks alcohol frequently and does not smoke. She has no history of allergies and uses only multivitamins daily. Her family history is positive for hypertension (her mother). She lives with her husband and has 3 children. The abdomen is tender and soft. Her bowel sounds are normal. Her heart rate is 115/min and blood pressure 110/75 mmHg. The lab studies are remarkable for leukocytosis (19.5), urea of 8.5, high CRP (145), high amylase (1200) and Glucose level of 15. Her abdominal CT scan revealed acute edematous interstitial pancreatitis with enlarged common bile duct and intrahepatic duct confirming gall stone pancreatitis. Her pregnancy test is negative and she is not breastfeeding.

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Metastatic Pancreatic Carcinoma Stage II Pancreatic Cancer Stage IIA Pancreatic Cancer Stage IIB Pancreatic Cancer Stage III Pancreatic Cancer Stage IV Pancreatic Cancer Unresectable Pancreatic Carcinoma Subject with histologically confirmed metastatic or locally advanced, unresectable pancreatic carcinoma Subject must have sufficient available archival tissue OR be willing to provide a baseline biopsy Subject must have progressed during or after first line treatment Subject must have computed tomography (CT) measurable disease by Response Evaluation in Solid Tumors (RECIST) 1.1 Subject must be able and willing to undergo disease assessment while on study and afterwards, if removed for reason other than progression Eastern Cooperative Oncology Group (ECOG) performance status =< 2 Absolute neutrophil count (ANC) >= 1.5 x 10^9/L Platelet count >= 100 x 10^9/L Hemoglobin >= 9 g/dL Total bilirubin level =< 1.5 x the upper limit of normal (ULN) range  Subject who have received systemic antineoplastic therapy (including unconjugated therapeutic antibodies and toxin immunoconjugates) or any investigational therapy within 2 weeks or within 5 half-lives of the investigational therapy prior to starting study treatment, whichever is shorter Subject who have received radiotherapy within 2 weeks prior to the first dose of study treatment. Localized radiation therapy for the treatment of symptomatic bone metastasis is allowed during that timeframe Subjects who have undergone major surgery =< 3 weeks prior to starting study drug or who have not recovered from side effects of such procedure Patients with multiple primary malignancies may be enrolled if non-pancreatic ductal adenocarcinoma (PDAC) tumor(s) does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen as determined by treating investigator and do not require active treatment Known brain metastases or cranial epidural disease unless adequately treated with radiotherapy and/or surgery (including radiosurgery) and stable for at least 4 weeks before first dose of study treatment. Eligible subjects must be neurologically asymptomatic and without corticosteroid treatment at the time of first dose of study treatment History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO (e.g. uncontrolled glaucoma or ocular hypertension, history of hyperviscosity or hypercoagulability syndromes) History of active major bleeding Patients whom thromboembolic prophylaxis is medically contraindicated per the treating investigator's assessment Current evidence of uncontrolled, significant intercurrent illness including, but not limited to, the following conditions Cardiovascular disorders