Polish A, et al. - Researchers delineate the objective pathologic response evoked by primary systemic therapy with 4 cycles of neoadjuvant FOLFIRINOX prior to surgery in 14 patients with resectable pancreatic cancer who received this treatment in a pilot study. Of the overall study sample, Evans grade I, grade IIa, grade IIb, and grade III response to the primary systemic therapy were noted in 4 (28.6%), 4 (28.6%), 2 (14.2%), and in 4 (28.6%) patients, respectively. No Evans grade IV responses were elicited. Destruction of < 10% of tumor cells was revealed in 28% of the specimens and > 90% destruction of tumor cells was seen in only 28%. The recognized heterogeneity in the biology of this cancer was corroborated by the observed significant variation in response and it was obvious that the efficacy displayed by FOLFIRINOX was not equal in all patients.