Irinotecan Hydrochloride Liposome Injection (II)in Combination With Oxaliplatin, 5-FU/LV Versus AG for First-line Treatment of Metastatic Pancreatic Cancer

This study is comparing two chemotherapy regimens as first-line treatment for pancreatic cancer that has spread to other parts of the body (metastatic). One combination includes a newer liposomal (special encapsulated) form of a drug called irinotecan combined with oxaliplatin and a standard chemo regimen, compared to a standard gemcitabine-plus-nab-paclitaxel regimen. **You may be eligible if...** - You have been diagnosed with pancreatic cancer that has spread and have not yet received chemotherapy for this stage - You are in reasonably good physical condition (ECOG score 0 or 1) - Doctors expect you to live at least 3 months or longer - You have at least one measurable tumor on imaging scans - You are willing and able to give written consent **You may NOT be eligible if...** - Your pancreatic cancer is a rare subtype like neuroendocrine, acinar cell, pancreatoblastoma, or solid-pseudopapillary tumor - You have cancer that has spread to the brain - You have a serious active infection requiring IV antibiotics - You have significant heart problems (heart failure, recent heart attack, uncontrolled irregular heartbeat, or unstable angina) Talk to your doctor to see if this trial is right for you.