Phase 2 trial: Gemcitabine (ribonucleotide reductase inhibitor) and Nab-paclitaxel (tubulin inhibitor) alternating with mFOLFIRINOX

This study evaluates the safety and effectiveness of alternating Gemcitabine plus Nab-paclitaxel with mFOLFIRINOX as neoadjuvant treatment for borderline resectable pancreatic ductal adenocarcinoma. Patients must have no prior systemic or radiation therapy and are receiving first-line treatment before surgery. Dartmouth-Hitchcock Medical Center leads this Phase 2 trial to assess if the alternating approach may improve resection outcomes.