Phase 2 mFOLFIRINOX Trial with Irinotecan Topoisomerase I Inhibition in Metastatic PDAC

This Phase 2 study by the University of Miami investigates whether ctDNA monitoring can guide early treatment changes in patients with treatment-naive metastatic pancreatic ductal adenocarcinoma. Participants receive standard mFOLFIRINOX—including 5-fluorouracil (thymidylate synthase inhibitor), oxaliplatin (DNA synthesis inhibitor), irinotecan (topoisomerase I inhibitor), and leucovorin—with a potential switch to Gemcitabine and Nab-Paclitaxel (or perhaps a clinical trial???) based on ctDNA response compared to conventional imaging.