NALIRIFOX Combined With PD-1 Sequential Radiotherapy Versus AG Combined With PD-1 Sequential Radiotherapy as First-line Treatment of Locally Advanced Pancreatic Cancer

This trial is comparing two different chemotherapy combinations — NALIRIFOX versus AG (gemcitabine + nab-paclitaxel) — each paired with an immune checkpoint inhibitor and followed by radiation, as first-line treatment for locally advanced pancreatic cancer that cannot be surgically removed. **You may be eligible if...** - You have been diagnosed with locally advanced pancreatic cancer confirmed by biopsy - Your cancer has been assessed as locally advanced (not yet spread to distant organs) per NCCN guidelines - You have not received any prior cancer treatment - You are in reasonably good physical condition (ECOG 0–2) **You may NOT be eligible if...** - You have received any prior treatment for this cancer - You have a serious active infection - You have autoimmune disease requiring immunosuppressive drugs - You have a bleeding disorder - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.