Phase II Study of 5-Fluorouracil, Oxaliplatin Plus Dasatinib (FOLFOX-D) in First-line Metastatic Pancreatic Adenocarcinoma

Inclusion Criteria:

- Pancreatic adenocarcinoma with evidence of metastatic disease on imaging

- Measurable disease (per RECIST 1.1)

- ECOG Performance Status 0-2

- No prior chemotherapy or radiotherapy for metastatic pancreatic cancer. Patients may
have received prior treatment for non-metastatic disease; however the diagnosis of
metastatic disease must have been made more than 6 months after completion of
treatment.

- Patients may have a history of other malignancies if there is no current evidence of
persistent or recurrent disease and they are not undergoing any active therapy
(including hormonal)

- Patent biliary system

- Patients receiving anti-coagulation treatment with an agent such as Coumadin or
heparin may be allowed to participate, provided they are on stable anti-coagulation
therapy with no active bleeding and have no condition that carries a high risk of
bleeding

- Adequate organ and marrow function

- Ability to take oral medication (dasatinib must be swallowed whole)

- Patient agrees to discontinue prohibited concomitant medications

- Age > 18 years

- Women of childbearing potential (WOCBP) must be using an adequate method of
contraception throughout the study and for at least 4 weeks after the last dose of
study drug.

- A male subject of fathering potential must use an adequate method of contraception
throughout the study and for at least 4 weeks after the last dose of study drug.

Exclusion Criteria:

- WOCBP who are unwilling or unable to use an acceptable method to avoid pregnancy for
the entire study period and for at least 4 weeks after the last dose of study drug.
Women who are pregnant or breastfeeding and sexually active fertile men not using
effective birth control if their partners are WOCBP are also excluded.

- History of known brain metastases or carcinomatous meningitis

- Recent major surgery (within 4 weeks) or minor surgery (within 2 weeks), excluding
placement of a vascular access device or biliary stent

- Uncontrolled diabetes

- Any sensory neuropathy > grade 1 at baseline

- Serious active or uncontrolled infection

- Concurrent medical condition which may increase the risk of toxicity including
clinically significant pleural or pericardial effusion, patients with known DPD
deficiency or patients with a history of allergic reactions attributed to
oxaliplatin, 5-FU or leucovorin.

- Cardiac Symptoms including unstable angina or stable angina markedly limiting
ordinary physical activity, NYHA class III or IV congestive heart failure, myocardial
infarction or stroke within 6 months of study enrollment, diagnosed congenital long
QT syndrome, any history of clinically significant ventricular arrhythmias, prolonged
QTc interval on pre-entry ECG or clinically significant peripheral vascular disease.

- Subjects with hypokalemia or hypomagnesemia if it cannot be corrected prior to
dasatinib administration

- History of significant bleeding disorder unrelated to cancer, including diagnosed
congenital bleeding disorders, diagnosed acquired bleeding disorder within one year
or ongoing or recent (≤ 3 months) significant gastrointestinal bleeding.

- History of any other disease, metabolic dysfunction, physical examination finding, or
clinical laboratory finding giving reasonable suspicion of a disease or condition
that contraindicates the use of protocol therapy, might affect the interpretation of
the results of the study, or that puts the subject at high risk for treatment
complications.

- Use of category I drugs that are generally accepted to have a risk of causing
Torsades de Pointes

- Use of potent CYP3A4 inhibitors that significantly increase dasatinib exposure

- Prisoners or subjects who are involuntarily incarcerated

- Subjects who are compulsorily detained for treatment of either a psychiatric or
physical (eg, infectious disease) illness

- Inability to comply with study and/or follow-up procedures