Chemoimmunotherapy and Radiation in Pancreatic Cancer

Inclusion Criteria: * Pancreatic adenocarcinoma * Locally advanced unresectable disease, or borderline resectable disease * ECOG (Eastern Cooperative Oncology Group)Performance Status 0 or 1 * Ability to provide consent and comply with study protocol * Women of child-bearing potential must have a negative pregnancy test and avoid pregnancy during the study Exclusion Criteria: * Age \< 18 * History of other malignancy in previous 2 years except carcinoma in situ of the cervix or bladder, or non-melanoma skin cancer * Previous chemotherapy or radiation therapy for pancreatic cancer or previous radiation to the target field * Clinically active autoimmune disease or active infection * History of heart attack within 90 days or stroke within 6 months, hypertension requiring change in blood pressure medications in the last 4 weeks, hypotension, uncontrolled arrhythmias, heart failure (NYHA \>= Class 2 in last 6 months), unstable angina, or angina during sexual activity * Use of nitrates or nitroglycerin * History of hereditary degenerative retinal disorders including retinitis pigmentosa * Chronic systemic corticosteroid use at supra-physiologic doses * Use of recreational drugs called 'poppers' like amyl nitrite and butyl nitrite * Blood test results (neutrophils \< 1000 /uL (microliter); hemoglobin \< 9 gm /dL; platelet count \< 1000 cells / uL; significant coagulopathy; significant liver or renal dysfunction