PurIST Classification-Guided Adaptive Neoadjuvant Chemotherapy by RNA Expression Profiling of EUS Aspiration Samples

This study uses a molecular test (called PurIST) on cells collected during an endoscopy biopsy of the pancreas to classify the cancer type and then personalize which chemotherapy regimen is used before surgery. The goal is to tailor treatment to the biology of each patient's pancreatic cancer. **You may be eligible if...** - You are 18 or older - You have been diagnosed with or are suspected to have pancreatic adenocarcinoma (pancreatic cancer) - Your cancer is resectable (operable) or borderline resectable based on CT or MRI - You are willing to undergo an endoscopic biopsy (EUS/FNA) for testing - Your organ function is adequate for chemotherapy **You may NOT be eligible if...** - Your cancer is not operable (locally advanced or metastatic) - You are in poor health (ECOG ≥ 2) - Your organ or bone marrow function does not meet the minimum thresholds Talk to your doctor to see if this trial is right for you.