Immunotherapy (EGFR FPBMC) for the Treatment of Locally Advanced, Metastatic, or Unresectable Pancreatic Cancer

Inclusion Criteria

• Histologically confirmed LAPC/UPC or MPC not eligible for curative intent therapy
• Received at least 1 line of chemotherapy and have stable disease (SD) or better for 3 months prior to enrollment. Therapy should consist of either a gemcitabine, fluorouracil (5FU)-based (including capecitabine) or albumin-bound paclitaxel-based regimen. Patients with actionable mutations should have received targeted therapy prior to enrollment on trial. Patients who qualify for immunotherapy due to mismatch repair protein/microsatellite stable and tumor mutational burden status should also have received immunotherapy prior to enrollment on trial
• Measurable disease by Immune-related Response Evaluation Criteria In Solid Tumors (irRECIST)
• Eastern Cooperative Oncology Group performance status (ECOG PS) 0-1
• Age ≥ 18 years
• Females of childbearing potential must have a negative pregnancy test within 7 days prior to enrollment/registration
• Females of childbearing potential and males must agree to use an effective method for contraception for the duration of the treatment with study drug plus 90 days (duration of sperm turnover). Males must also abstain from sperm donations during study treatment and for at least 90 days after the last dose of study drug
• Absolute neutrophil count (ANC) ≥ 500/mm^3 (within 14 days prior to registration)
• Absolute lymphocyte count (ANC) ≥ 400/mm^3 (within 14 days prior to registration)
• Platelets ≥ 75,000/mm^3 (within 14 days prior to registration)
• Hemoglobin ≥ 8 g/dL (within 14 days prior to registration)
• Serum creatinine < 2.0 mg/dL OR calculated or measured creatinine clearance ≥ 50 ml/min (within 14 days prior to registration)
• Bilirubin ≤ 2 mg/dl (biliary stent is allowed) (within 14 days prior to registration)
• Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase [SGPT]) ≤ 5.0 x upper limit of normal (ULN) (within 14 days prior to registration)
• Alpha 1, 3 galactose immunoglobulin E (IgE) (“alpha gal”) < 0.35 IU/ml or “negative” (within 14 days prior to registration) * Alpha gal testing must be within the regular screening period
• Ability to provide informed consent and provision of written informed consent
• Stated willingness to comply with all study procedures and availability for the duration of the study
• Adequate cardiac function as defined as: * No uncontrolled angina or severe ventricular arrhythmias * No clinically significant pericardial disease * No history of myocardial infarction (MI) in the last year before registration * No class 3 or higher New York Heart Association Congestive Heart Failure

Exclusion Criteria

• Known hypersensitivity to cetuximab
• Treatment with investigational agent within 3 weeks prior to registration
• Serious non-healing wound, ulcer, bone fracture, major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to registration
• Known active liver disease, HIV+ or evidence of active hepatitis C or B virus; bleeding or condition associated with high-risk bleeding (anticoagulation is allowed)
• Active infection; prior antibiotic/antifungal/antiviral therapies within 2 weeks prior to registration
• History of a myocardial infarction within 1 year prior to registration
• Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
• Autoimmune disease that has required systemic treatment with chronic steroids or immunosuppressive therapy in the 2 years prior to registration (thyroxine, insulin, or corticosteroid replacement is allowed)
• History or evidence of any condition that might confound the results of the trial, interfere with the subject’s participation, or is not in the best interest of the subject to participate, in the opinion of the treating investigator
• Females must not be currently breast feeding
• The treating investigator feels the patient is not able to be compliant
• History of active TB (Bacillus Tuberculosis)
• Has received a live vaccine within 30 days of registration
• Prisoners or patients who are incarcerated
• Patients who are compulsorily detained for treatment of a psychiatric or physical illness