Were the surgical margins and lymph nodes all clean, making this just a normal "adjuvant" treatment? Or was there any leftover cancer detected that needed aggressive treatment?

In my case, I was diagnosed at age 58 w/ resectable Stage-II PDAC, had 6 months of Folfirinox, clean Whipple, NO adjuvant treatment (all clean DNA tests and MRIs), then recurrence at surgical site w/ metastasis 4 months later, and began more chemo shortly after that.

The Folfirinox was only partially effective at shrinking the tumor (pancreas head) or reducing CA19-9. The new regimen (Gemcitabine + Abraxane + Cisplatin) has been slightly more effective on tumor size and much more effective reducing CA19-9. More tumors appeared early, but they are not growing now.

I was told my ATM mutation was sensitive to platinum-based agents, so I thought the Oxaliplatin in Folfirinox would do a bang-up job, but no... So I wasn't sure, but am pleasantly surprised that the Cisplatin in my cocktail seems to be helping, at least for now.

Tolerability: I found the Folfirinox to be a little more miserable than the GemAbraxCis, especially the 46-hour pump you take home with Folfirinox. Got peripheral neuropathy from both. Minor hair loss and graying with Folfirinox, total loss on GemAbraxCis.

Summary: You might ask the medical oncologists how often they'll test your response to treatment and with which methods (imaging, CA19-9, Signatera/ctDNA). My emphasis would be on how quickly they can determine which (if either) works better so you can switch (if necessary) w/o wasting a whole lot of time or risking spread of the disease. You may have mutations that guide treatment in a totally different direction.

Please post if they give you a good rationale for their decision, and good luck!