NeoFOL-R: This trial is investigating the use of chemotherapy drugs (called mFOLFIRINOX) in people with pancreatic cancer before they have surgery, rather than the usual process of using these drugs after surgeryEfficacy of Neoadjuvant FOLFIRINOX in Resectable pancreatic cancer: An international multicenter Randomized, controlled trial (NeoFOL-R) - Australian protocol

Inclusion

Patients must meet all of the following criteria to participate in this study.
1. Age: 18 – 80 years
2. Patients with an Eastern Cooperative Oncology Group (ECOG) score of 0 – 2
3. Pancreatic ductal adenocarcinoma diagnosed by histological examination (histologic or cytopathological)
4. Patients evaluated for resectable pancreatic cancer on preoperative imaging as follows (NCCN guidelines for pancreatic adenocarcinoma version 2.2021)
a. There is no arterial tumour contact (celiac artery, superior mesenteric artery, or common hepatic artery).
b. There is no tumour contact with the superior mesenteric vein or portal vein or equal to or less than 180°contact without vein contour irregularity.
5. No distant metastases on preoperative imaging
6. Patients with adequate organ function
a) Bone marrow function: WBC greater or equal to 3,000/mm3 or absolute neutrophil count (ANC) greater or equal to 1,500/mm3, platelet greater or equal to 100 K/mm3
b) Liver function: bilirubin equal or less than 3 × the upper normal limit (equal to or less than 5.0 mg/dL), AST/ALT equal to or less than 5 the upper normal limit (less than 200 IU/L)
c) Renal function (Creatinine clearance (Cr) equal to or greater than 60 mL/min) or (Cr < 1.5 x upper normal limit)
7. Persons physically capable of undergoing surgery
8. Those who consented to the clinical trial