Neoadjuvant Chemotherapy for Pancreatic Cancer

This trial tests a new sequence of chemotherapy drugs for people with pancreatic cancer. It examines the effects—both positive and negative—of administering Gemcitabine (Gemzar) and nab-Paclitaxel (Abraxane) first, followed by mFOLFIRINOX (modified FOLFIRINOX). While these are standard treatments, they are not typically used in this order. The researchers aim to determine if this sequence can improve outcomes for those with borderline resectable or locally advanced pancreatic adenocarcinoma. Participants must have a confirmed diagnosis of pancreatic adenocarcinoma and meet specific health criteria. As a Phase 2 trial, this research focuses on assessing the treatment's effectiveness in an initial, smaller group of people.

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Research has shown that using Gemcitabine, Nab-paclitaxel, and mFOLFIRINOX together is generally safe for treating pancreatic cancer. Studies have compared these treatments to evaluate their effectiveness and safety. Both Nab-paclitaxel with Gemcitabine and mFOLFIRINOX have proven effective for advanced pancreatic cancer and have received FDA approval for this use.

Although these drugs are potent, they can cause side effects such as tiredness, nausea, and low blood cell counts. These side effects are common with chemotherapy and can usually be managed. These treatments have been used for a long time, providing a solid understanding of their safety.

Most treatments for pancreatic cancer involve chemotherapy regimens like FOLFIRINOX and gemcitabine with nab-paclitaxel. However, this new approach combines both these regimens in a unique sequence to maximize effectiveness. Researchers are excited because it starts with gemcitabine and nab-paclitaxel to shrink the tumor, then switches to mFOLFIRINOX, a potent combo of drugs, aiming for better tumor reduction before surgery. This strategic sequencing could potentially improve outcomes by hitting the cancer with a broader spectrum of chemotherapy agents.

In this trial, participants will receive a treatment regimen starting with Gemcitabine and nab-Paclitaxel, followed by mFOLFIRINOX, to evaluate its effectiveness for treating pancreatic cancer. Research has shown that starting with Gemcitabine and nab-Paclitaxel, followed by mFOLFIRINOX, can help patients live longer and increase the chances of successful surgery after treatment. The FDA has already approved Gemcitabine and nab-Paclitaxel for advanced pancreatic cancer, confirming their effectiveness together. FOLFIRINOX, another approved treatment, is also associated with better survival and more successful surgeries for some patients. While using these treatments in this specific order is new, each has proven benefits, making this approach promising for patients.⁶⁷⁸⁹¹⁰