In patients with resected PDAC treated with adjuvant FOLFIRINOX who recur from 1-3 years post completion of adjuvant therapy, do you consider retreatment with FOLFIRINOX or gemcitabine/nab-paclitaxel in the absence of a clinical trial?

One can use either depending on how long after adjuvant completion date although I will lean towards gem/nab-paclitaxel more. But could be either depending on PS, preexisting neuropathy, patient preference, age, site(s) of recurrences, as important considerations. an asymptomatic lung recurrence, tw...

If there is no clinical trial, I would lean towards FOLFIRINOX if the patient is close to 2-3 years from completion of adjuvant therapy and has grade 1 or less neuropathy and a good ECOG. The use of agents also perhaps can vary on the disease burden and the ability of the patient to tolerate therapy...

If one year post adjuvant folfirinox, minimal neuropathy and PS0-1, would favor folfirinox. Prefer not utilizing gem/abraxane because, after progression on this combination, PS might not allow retreatment with folfirinox. Of course, if a clinical trial is available, this would always be my first con...