de Jesus VHF, et al. - Experts compared the survival outcomes, response rates and toxicity of patients treated with standard vs modified FOLFIRINOX in metastatic pancreatic adenocarcinoma (MPA). The same activity against MPA as seen with standard FOLFIRINOX was seen with modified FOLFIRINOX. Toxicity was not significantly different possibly due to patient selection and a higher dose reduction rate in the standard FOLFIRINOX arm. An important prognostic marker was neutrophil-to-lymphocyte ratio (NLR).