Currently, FOLFIRINOX is the only combination regimen that has demonstrated a statistical and clinical survival benefit over gemcitabine. The phase III study reported a 4.3 month survival benefit over gemcitabine (11.1 vs. 6.8 months) in the first-line treatment of patients with metastatic pancreatic adenocarcinoma and good ECOG performance status, no cardiac ischaemia, and normal or nearly normal bilirubin levels. However, this was at the expense of increased toxicity, including higher rates of febrile neutropenia.