Murphy JE, et al. - In 49 patients with locally advanced pancreatic adenocarcinoma, researchers investigated how total neoadjuvant treatment with FOLFIRINOX (fluorouracil, leucovorin, oxaliplatin, and irinotecan), losartan, and chemoradiation therapy is associated with margin-negative (R0) resection rates. Among all eligible participants in this single-arm phase 2 trial, an R0 resection rate of 61% was noted. Surgical resection was undertaken in 34 of 49 patients. In this subset, R0 resection was achieved in 30 of 49 patients. These findings support that in this historically incurable disease, an R0 resection rate that went beyond expectations was achieved in correlation with total neoadjuvant FOLFIRINOX and losartan followed by chemoradiotherapy, an outcome associated with prolonged progression-free and overall survival.