Efficacy of Gembrax Followed by Folfirinox Versus Folfirinox Alone in First Metastatic Line Pancreatic Cancer Patients

This study tests whether starting with Gembrax (gemcitabine + nab-paclitaxel) for two months, then switching to FOLFIRINOX chemotherapy, works better than FOLFIRINOX alone as first-line treatment for metastatic pancreatic cancer. The idea is that an initial different regimen may help sensitize the cancer to the second regimen. **You may be eligible if...** - You are aged 18–75 with confirmed metastatic pancreatic adenocarcinoma - You have not yet received chemotherapy for metastatic disease (prior treatment for non-metastatic disease is allowed if it was at least 6 months ago) - You are in good health (WHO performance status 0 or 1) with adequate blood and organ function **You may NOT be eligible if...** - You have previously received chemotherapy for metastatic pancreatic cancer - You have severe heart, liver, or kidney problems that make chemotherapy unsafe - You have a uracilemia level above 16 ng/mL (a marker that indicates risk of serious 5-FU toxicity) Talk to your doctor to see if this trial is right for you.