Ozaka M, et al. - Researchers tested a modified FOLFIRINOX regimen (intravenous oxaliplatin 85 mg/m², irinotecan 150 mg/m², 5-FU infusion 2400 mg/m² over 46 h, no bolus 5-FU) for chemotherapy-naïve patients with metastatic pancreatic cancer (MPC), with a focus on overall survival and the incidence of grade 3 or higher neutropenia. No patients received prophylactic pegfilgrastim. In first prospective study of modified FOLFIRINOX in Asia, the median overall survival of 11.2 months and the median progression-free survival of 5.5 months was reported, with a 47.8% incidence of grade 3 or higher neutropenia. With an improved safety profile, modified FOLFIRINOX demonstrated maintained efficacy in MPC without prophylactic pegfilgrastim.