Pancrelipase in People With Pancreatic Ductal Adenocarcinoma (PDAC)

Inclusion criteria

• Histopathologic or cytologic diagnosis of pancreatic adenocarcinoma, or adenosquamous cancer, or any non-neuroendocrine primary pancreas variant, including acinar cancer.
• De novo or recurrent diagnosis of previously untreated stage IV PDAC with intent to receive FOLFIRINOX/mFOLFIRINOX.
• ECOG 0-2.
• No use of pancreatic enzyme replacement therapy within prior 2 weeks.
• Patients with biliary obstruction are eligible provided biliary stenting has or will occur before treatment with FOLFIRINOX.
• Ability to understand and the willingness to sign an informed consent document.
• Ability to swallow capsules.
• Age ≥18 years.
• Anticipated life expectancy of at least 6 months.

Exclusion criteria

• Chronic illness associated with malabsorption (celiac disease, cystic fibrosis, chronic pancreatitis, Crohn's disease).
• Fibrosing colonopathy.
• Prior history of surgical resection of the pancreas or gastric bypass.
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to Pancrelipase.
• Patients cannot receive radiation, IRE, or other localized therapy directed to the pancreas while on study.