Gene test may guide smarter chemo for pancreatic cancer

This phase II trial tests whether choosing chemotherapy based on a specific gene mutation (SMAD4) can improve outcomes for people with pancreatic cancer that is or may be surgically removable. The SMAD4 gene normally acts as a brake on tumor growth, but when it's mutated, tumors can be more aggressive and resistant to standard treatments. Instead of a one-size-fits-all approach, the trial assigns patients to either gemcitabine with nab-paclitaxel or FOLFIRINOX based on their tumor's SMAD4 status, aiming to increase the chance of complete surgical removal. The study enrolls about 125 participants and will measure how many achieve successful surgery.