@wpprescott My husband's oncologist told us that if there is standard-of-care chemotherapy still available, do that first. According to onco, trials are last options, although I hear of people going for trials in the hope of a more permanent 'fix'. Right now it seems you have either Folfirinox or Gem-Nab. My husband found Folfirinox harder and his markers climbed. Onco switched to Gem-Abraxane and my husband was on it for 15 months - side effects minimal and tolerable. He managed to make 3 short trips (including flying 6 hours) during that time. Now he has localised recurrence at the resected edge of pancreas. Onco said this is indication of the cancer's resistance to Gem-Abraxane so onco switched to a combination of VMAT and Capecitabine. This cancer journey is not a straight level road unfortunately but the thing is to grit our teeth and move forward. You HAVE OPTIONS - that has to be good.