2-[bis(2 -chloroethyl)amino]tetrahydro-2H-1,3,2-oxazaphosphorine 2-oxide monohydrate (cyclophosphamide) 2. cis-[(1 R,2 R)-1,2-cyclohexanediamine-N,N’] [oxalato(2-)- O,O’] platinum ( oxaliplatin ) 3. 5’-deoxy-5-fluoro-N-[(pentyloxy) carbonyl]- cytidine (capecitabine) 4. 5-fluoro-2,4 (1H ,3H)-pyrimidinedione (5-Fluorouracil) 5. L-Glutamic acid, N -[4-[[(2-amino -5-formyl -1,4,5,6,7,8-hexahydro-4-oxo-6- pteridinyl)methyl]amino]benzoyl] -, calcium salt (l eucovorin ) 6. Benzenepropanoic acid, β-(benzoylamino)- α-hydroxy -(2aR, 4S, 4aS, 6R, 9S, 11S, 12S, 12aR, 12bS)-6,12b-bis(acetyloxy)-12-(benzoyloxy)-2a, 3, 4, 4a, 5, 6, 9, 10, 11, 12, 12a, 12b- dodecahydro-4,11-dihydroxy-4a, 8, 13, 13- tetramethyl -5-oxo-7,11-methano-1H- cyclodeca[3,4]benz[1,2-b]oxet-9- y1ester, (αR,βS)-(9CI) bound to albumin (n ab-paclitaxel ) 7. Recombinant human anti- VEGF IgG1 monoclonal (b evacizumab ) 8. Fully human anti- PD-L1 IgG1 lambda monoclonal antibody (avelumab) Investigational 1. Recombinant human super agonist interleukin -15 (IL- 15) complex (ALT -803) 2. NK-92 cells (aNK for Infusion) 3. Ad5 [E1-, E2b-]- CEA 4. GI-4000 Ras vaccine Title of Study: NANT Pancreatic Cancer Vaccine: combination immunotherapy in subjects with pancreatic cancer who have progressed on or after standard-of- care therapy. Study Number: QUILT -3.039 Study Phase: Phase 1b/2 (S imon ’s two-stage optimal design). Confidential and Proprietary 4 NANT Pancreatic Cancer Vaccine NantCell, Inc. Clinical Trial Protocol: QUILT -3.039 Amendment 2 Study Objectives: Phase 1b • The primary objective is to evaluate the overall safety profile of the NANT regimen in subjects with pancreatic cancer who have progressed after standard -of-care (SoC) therapy. • Secondary objectives are to obtain preliminary estimates of efficacy by objective response rate (ORR), progression -free survival (PFS), overall survival (OS) , duration of response (DOR), disease control rate (DCR), and patient -reported outcomes (PROs) of pancreatic cancer symptoms. • Exploratory objectives include determination of any correlations between tumor molecular profiles and efficacy, examination of cell phenotypes in tumors and whole blood, and assessment of circulating tumor RNA (ctRNA) for detection of PD- L1 expression. Phase 2 • The primary objective is to determine the efficacy of the NANT regimen as assessed by ORR . • The secondary objectives are to determine additional measures of efficacy (PFS , DOR, DCR , PROs of pancreatic cancer symptoms), and ad ditional safety data. • Exploratory objectives include determination of any correlations between tumor molecular profiles and efficacy, examination of cell phenotypes in tumors and whole blood, and assessment of circulating tumor RNA (ctRNA) for detection of PD- L1 expression. Study Design: This is a phase 1b/2 study to evaluate the safety and efficacy of metronomic combination therapy in subjects with pancreatic cancer who have progressed on or after previous SoC first line therapy and chemotherapy. Phase 2 will be based on Simon’s two -stage optimal design. The initial 3 subject s will be enrolled in a staggered fashion, with a 21-day interval between each subject to enable the capture and monitoring of any acute and subacute toxicities . Treatment will be administered in two phases, an induction and a maintenance phase, as described below. Subjects will continue induction treatment for up to 1 year, until they experience progressive disease ( PD) or experience unacceptable toxicity (not correctable with dose reduction), withdraw consent, or the investigator feels it is no longer in the subject’s best interest to continue treatment. Those who have a complete response ( CR) in the induction phase will enter the maintenance phase of the study. Subjects may remain on the maintenance phase of the study for up to 1 year. Treatment will continue throughout the maintenance phase until the subject experiences PD or unacceptable toxicity, withdraws consent, or the investigator feels it is no longer in the subject’s best interest to continue treatment. Tumor biopsies and tumor molecular profiling will be conducted at screening and at the end of the initial induction (8 weeks) and during a potential prolonged induction phase (depending on response). Confidential and Proprietary 5 NANT Pancreatic Cancer Vaccine NantCell, Inc. Clinical Trial Protocol: QUILT -3.039 Amendment 2 In addition , circulating RNA and exploratory immune analyses will be carried out on blood collected every 4 weeks during the induction ph ase and every 8 weeks during the maintenance phase. Tumors will be assessed at screening, and tumor response will be assessed every 8 weeks during the induction phase, and every 3 months during the maintenance phase by computed tomography (CT), magnetic resonance imaging (MRI) , or positron emission tomography (PET) of target and non- target lesions in accordance with Response Evaluation Criteria in Solid Tumors ( RECIST ) Version 1.1 and immune- related response criteria (irRC). Induction Phase: The induction phase will consist of repeated 2 week cycles of low-dose radiation and metronomic chemotherapy. The treatment regimen of cyclophosphamide, oxaliplatin, 5-FU/leucovorin, nab-paclitaxel , bevacizumab , ALT -803, aNK, vaccine s (Ad5 and GI-4000), and avelumab will be repeated every 2 weeks. Concurrent stereotactic body radiotherapy ( SBRT ) will be given during the first four 2 -week cycles. Radiation will be administered to all feasible tumor sites using SBRT, as described in Section 5.1.5.1 . Techniques allowed include linear- accelerator based therapies (3D and intensity -modulated radiation therapy [IMRT]) and gamma and cyber knife. The induction t reatment will continue for up to 1 year, until the subject experiences PD or unacceptable toxicity (not correctable with dose reduction), withdraws consent, or the investigator feels it is no longer in the subject’s best interest to continue treatment. Subjects that have a CR in the induction phase will enter the maintenance phase of the study. Response assessments using CT /MRI evaluated in accordance with RECIST Version 1.1 and irRC will be performed every 8 weeks during the induction phase. Days 1 –5 and 8–12, every 2 weeks : • Cyclophosphamide (50 mg twice a day [BID]). Day 1 and 8, every 2 weeks : • Oxaliplatin (40 mg/m2 IV) • Nab-paclitaxel (125 mg IV) Day 1 every 2 weeks: • Bevacizumab (5 mg /kg IV) Days 1, 3, 5, 8, 10 and 12 , every 2 weeks: • 5-fluorouracil (400 mg/m2 over 24 hours as a continuous infusion) • Leucovorin (20 mg/m2 IV bolus) Day 8 , 22, 36, 50 (every 2 week s for 4 doses) : • SBRT (8 Gy) Day 9, every 2 weeks: • ALT -803 (10 μg/kg subcutaneously [ SC] 30 minutes prior to aNK infusion) Confidential and Proprietary 6 NANT Pancreatic Cancer Vaccine NantCell, Inc. Clinical Trial Protocol: QUILT -3.039 Amendment 2 Day 9 and 11, every 2 weeks: • aNK (2 x 109 cells/dose IV ) Day 5, 19, 33 (every 2 weeks for 3 doses then every 8 weeks thereafter) : • Ad5 [E1-, E2b-]- CEA (5 x 1011 VP/dose SC ) • GI-4000 (40 yeast units [ YU] SC, 2 hours after administration of Ad5 [E1-, E2b-]- CEA ; use dependent on genomic sequencing indicating required KRAS mutations) Day 8, every 2 weeks: • Avelumab (10 mg/kg IV over 1 h) Maintenance Phase: The duration of the maintenance phase will be up to 1 year following completion of the last treatment in the induction phase. Treatment will continue throughout the maintenance phase unless the subject experiences PD or unacceptable toxicity, withdraws consent, or the investigator feels it is no longer in the su bject’s best interest to continue treatment. Response assessments using CT/MRI evaluated in accordance with RECIST Version 1.1 and irRC will be performed every 3 months during the maintenance phase. Days 1 –5 and 8–12 , every 2 weeks: • Cyclophosphamide (50 mg BID ) • Capecitabine (650 mg/m2 PO BID ) Day 1 , every 2 weeks: • Nab-paclitaxel (125 mg IV) • Bevacizumab (5 mg /kg IV) • Avelumab (10 mg/kg IV over 1 h) Day 2, every 2 weeks: • ALT -803 (10 µg/kg SC) (30 minutes prior to aNK infusion) • aNK (2 x 109 cells/dose IV ) Day 5, every 8 weeks thereafter: • Ad5 [E1-, E2b-]- CEA ( 5 x 1011 VP/dose SC ) • GI-4000 ( 40 YU SC , 2 hours administration of Ad5 [E1-, E2b-]- CEA ) Confidential and Proprietary 7 NANT Pancreatic Cancer Vaccine NantCell, Inc. Clinical Trial Protocol: QUILT -3.039 Amendment 2 Phase 1 b Primary Endpoint : • Incidence of treatment- emergent adverse events (AEs) and serious AEs (SAEs), graded using the National Cancer Institute (NCI ) Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03.