Gemcitabine, Nab-Paclitaxel, and Bosentan for the Treatment of Unresectable Pancreatic Cancer

This study is testing whether adding a drug called bosentan (typically used for pulmonary arterial hypertension) to standard chemotherapy can improve outcomes for patients with pancreatic cancer that cannot be surgically removed. Bosentan blocks a protein pathway that tumors use to protect themselves from chemotherapy, potentially making the cancer more vulnerable to treatment. **You may be eligible if...** - You are an adult with unresectable (inoperable) pancreatic cancer - You are a candidate for gemcitabine plus nab-paclitaxel, or mFOLFIRINOX chemotherapy - You weigh at least 40 kg - Your blood counts, kidney, and liver function are within acceptable ranges - You are willing to provide a tumor tissue sample (archival or fresh biopsy if safe) **You may NOT be eligible if...** - You have previously received chemotherapy for metastatic pancreatic cancer - Your liver or kidney function is significantly impaired Talk to your doctor to see if this trial is right for you.