A Phase 2, Randomized, Multicenter, Open-Label Study of the Efficacy and Immune Response of the Sequential Administration of GVAX Pancreas Vaccine Alone or Followed by CRS-207 in Adults With Metastatic Pancreatic Adenocarcinoma

Inclusion Criteria:

- Have histologically proven malignant adenocarcinoma of the pancreas; measurable
disease is not required. (Subjects with mixed histology will be included if the
predominant component is adenocarcinoma. Subjects must have metastatic disease.)

- Have received or refused at least one chemotherapy regimen

- Be at least 18 years of age

- Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

- Have an anticipated life expectancy of greater than 12 weeks

- For women and men of childbearing potential, a medically acceptable method of highly
effective contraception (oral hormonal contraceptive, condom plus spermicide, or
hormone implants) must be used throughout the study period and for 28 days after
their final vaccine administration. (A barrier method of contraception must be
employed by all subjects [male and female], regardless of other methods.)

- Be willing and able to give written informed consent, and be able to comply with all
study procedures

- Have adequate organ function as defined by specified laboratory values

Exclusion Criteria:

- Currently have or have history of certain study-specified heart, liver, kidney, lung,
neurological, immune or other medical conditions

- Have a known history or evidence of brain metastases

- Have any evidence of hepatic cirrhosis or clinical or radiographic ascites

- Have clinically significant and/or malignant pleural effusion

- Known or suspected hypersensitivity to any component of GVAX Pancreas vaccine or
CRS-207, or known allergy to both penicillin and sulfa

- Received an investigational product within 28 days of study treatment or planned to
receive within 28 days after vaccine administration

- Used any systemic steroids within 28 days of study treatment

- Use more than 3 g/d of acetaminophen

- An artificial (prosthetic) joint or other artificial implant or device that cannot be
easily removed (with some exceptions for dental and breast implants and biliary
stents and mediports)

- Major surgery or significant traumatic injury (or unhealed surgical wounds) occurring
within 28 days prior to receiving study drug, or planned surgery requiring general
anesthesia

- Infection with HIV or hepatitis B or C at screening

- Any immunodeficiency disease or immunocompromised state or active autoimmune disease
or history of autoimmune disease requiring systemic steroids or other
immunosuppressive treatment

- Be a woman who is pregnant or breastfeeding

- Unable to avoid close contact with another individual known to be at high risk of
listeriosis (e.g., newborn infant, pregnant woman, HIV-positive individual) during
the course of CRS-207 treatment until completion of antibiotic regimen

- Conditions, including alcohol or drug dependence, intercurrent illness, or lack of
sufficient peripheral venous access, that would affect the patient's ability to
comply with study visits and procedures