Results of a new clinical trial show that patients with resected pancreatic ductal adenocarcinoma treated with a modified FOLFIRINOX (mF) regimen had longer survival than those treated with gemcitabine. A total of 493 patients were randomly allocated to either treatment for 24 weeks. At 33.6 months median follow-up, median disease-free survival was 21.6 months and 12.8 months (P < 0.001) and 3-year disease-free survival was 39.7% and 21.4% in the mF group and the gemcitabine group, respectively. Median overall survival was 54.4 months and 35.0 months (P = 0.003) and 3-year overall survival was 63.4% and 48.6% in the mF group and the gemcitabine group, respectively. 75.9% in the mF group and 52.9% in the gemcitabine group experienced grade 3 or 4 adverse events.