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Patients meeting the eligibility criteria will be randomized after a minimum of two months of induction chemotherapy. These patients will be required to have no biopsy-proven distant disease on repeat staging studies before randomization. Patients who have radiologically equivocal evidence of distant metastatic disease \(small lung nodules, or liver lesions that cannot be definitively characterized, etc.\) are also eligible for enrollment. Patients with biopsy-proven metastatic disease are not eligible. ) /Pg 7 0 R /K [2] >> endobj 36 0 obj << /Type /StructElem /S /P /P 165 0 R /E (NCT#: NCT03322995) /Pg 7 0 R /K [3] >> endobj 37 0 obj << /Type /StructElem /S /P /P 166 0 R /E (Key Inclusion:) /Pg 7 0 R /K [4] >> endobj 38 0 obj << /Type /StructElem /S /P /P 166 0 R /E (Key Exclusion:) /Pg 7 0 R /K [9] >> endobj 39 0 obj << /Type /StructElem /S /P /P 167 0 R /E (Study PI: ) /Pg 7 0 R /K [12] >> endobj 40 0 obj << /Type /StructElem /S /P /P 167 0 R /E (Dr. Kathleen Christians) /Pg 7 0 R /K [13] >> endobj 41 0 obj << /Type /StructElem /S /P /P 168 0 R /E (Clinical Research) /Pg 7 0 R /K [14] >> endobj 42 0 obj << /Type /StructElem /S /P /P 168 0 R /E (Coordinator: ) /Pg 7 0 R /K [15] >> endobj 43 0 obj << /Type /StructElem /S /P /P 168 0 R /E (Grace Westerman) /Pg 7 0 R /K [16] >> endobj 44 0 obj << /Type /StructElem /S /P /P 168 0 R /E (Phone: 414-805-8986) /Pg 7 0 R /K [17] >> endobj 45 0 obj << /Type /StructElem /S /P /P 169 0 R /E (ECOG performance status of < 2) /Pg 7 0 R /K [5] >> endobj 46 0 obj << /Type /StructElem /S /P /P 170 0 R /E (Histologically confirmed adenocarcinoma of the pancreas) /Pg 7 0 R /K [6] >> endobj 47 0 obj << /Type /StructElem /S /P /P 171 0 R /E (Clinical stage resectable or borderline resectable pancreatic adenocarcinoma) /Pg 7 0 R /K [7] >> endobj 48 0 obj << /Type /StructElem /S /P /P 172 0 R /E /Pg 7 0 R /K [8] >> endobj 49 0 obj << /Type /StructElem /S /P /P 173 0 R /E (Received chemotherapy and/or radiation within 3 years prior to study enrollment) /Pg 7 0 R /K [10] >> endobj 50 0 obj << /Type /StructElem /S /P /P 174 0 R /E (History of prior malignancy except for adequately treated in situ cancer of the cervix or basal cell or squamous cell skin cancer or localized prostate cancer with a normal PSA within the last 3 years) /Pg 7 0 R /K [11] >> endobj 51 0 obj << /Type /StructElem /S /P /P 175 0 R /E (Clinical Trial Name: PurIST Classification-Guided Adaptive Neoadjuvant Chemotherapy by RNA Expression Profiling of EUS SAmples Study \(PANCREAS\)) /Pg 7 0 R /K [18] >> endobj 52 0 obj << /Type /StructElem /S /P /P 176 0 R /E (Study Design: This is an open-label, single arm, phase II study in patients with resectable and borderline resectable pancreatic cancer. The study intervention involves molecular profiling Purity Independent Subtyping of Tumors \(PurIST\) subtyping of pretreatment Endoscopic Ultrasound Fine Needle Aspiration \(EUS/FNA\) samples to determine pancreatic cancer subtype. Neoadjuvant therapy is directed based on the molecular subtype \(classical vs. basal\). 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Biopsy must have been completed prior to start of treatment) /Pg 7 0 R /K [26] >> endobj 65 0 obj << /Type /StructElem /S /P /P 184 0 R /E (Clinical stage consistent with resectable or borderline resectable or locally advanced type A adenocarcinoma of the pancreas, based on CT or MRI findings) /Pg 7 0 R /K [27] >> endobj 66 0 obj << /Type /StructElem /S /P /P 185 0 R /E /Pg 7 0 R /K [28] >> endobj 67 0 obj << /Type /StructElem /S /H2 /T (NEW PATIENT COORDINATOR: 414-805-6849) /E (NEW PATIENT COORDINATOR: 414-805-6849) /Alt () /Pg 7 0 R >> endobj 68 0 obj << /Type /StructElem /S /P /E (Version: 02.04.25) /Alt () /Pg 7 0 R >> endobj 69 0 obj << /Type /StructElem /S /Figure /P 30 0 R /Pg 7 0 R /K [34] >> endobj 70 0 obj << /Type /StructElem /S /P /P 186 0 R /E (Clinical Trial Name: PurIST Classification-Guided Adaptive Neoadjuvant Chemotherapy by RNA Expression Profiling of EUS SAmples Study \(PANCREAS\) Continued) /Pg 8 0 R /K [0] >> endobj 71 0 obj << /Type /StructElem /S /P /P 187 0 R /E (Key Exclusion:) /Pg 8 0 R /K [1] >> endobj 72 0 obj << /Type /StructElem /S /P /P 188 0 R /E (Received chemotherapy and/or radiation within three years prior to study enrollment) /Pg 8 0 R /K [2] >> endobj 73 0 obj << /Type /StructElem /S /P /P 189 0 R /E (Previous history of another malignancy w/in 3 years of study \(other than cured basal or squamous cell carcinoma and other in situ carcinomas that were completely treated or localized prostate cancer with normal prostate specific antigen\)) /Pg 8 0 R /K [3] >> endobj 74 0 obj << /Type /StructElem /S /P /P 190 0 R /E (Clinical Trial Name: Molecular Profile-related Individualized Targeted Therapy in Resected Pancreatic Cancer with High-Risk of Cancer Recurrence \(PROTECT-PANC\)) /Pg 8 0 R /K [4] >> endobj 75 0 obj << /Type /StructElem /S /P /P 191 0 R /E (Study Design: This is a prospective, open-label therapeutic interventional investigation designed to interrogate the efficacy and safety of individualized matched therapies in patients with pancreatic cancer at high risk of disease recurrence post-surgery.) /Pg 8 0 R /K [5] >> endobj 76 0 obj << /Type /StructElem /S /P /P 192 0 R /E (NCT#: NCT06228599) /Pg 8 0 R /K [6] >> endobj 77 0 obj << /Type /StructElem /S /P /P 193 0 R /E (Key Inclusion:) /Pg 8 0 R /K [7] >> endobj 78 0 obj << /Type /StructElem /S /P /P 194 0 R /E (Study PI: ) /Pg 8 0 R /K [24] >> endobj 79 0 obj << /Type /StructElem /S /P /P 194 0 R /E (Dr. Mandana Kamgar) /Pg 8 0 R /K [25] >> endobj 80 0 obj << /Type /StructElem /S /P /P 195 0 R /E (Clinical Research) /Pg 8 0 R /K [26] >> endobj 81 0 obj << /Type /StructElem /S /P /P 195 0 R /E (Coordinator: ) /Pg 8 0 R /K [27] >> endobj 82 0 obj << /Type /StructElem /S /P /P 195 0 R /E (Dawn Carini) /Pg 8 0 R /K [28] >> endobj 83 0 obj << /Type /StructElem /S /P /P 195 0 R /E (Phone: 414-805-0789) /Pg 8 0 R /K [29] >> endobj 84 0 obj << /Type /StructElem /S /P /P 196 0 R /E (Pathologically confirmed pancreatic cancer \(excluding neuroendocrine histology\).) /Pg 8 0 R /K [8] >> endobj 85 0 obj << /Type /StructElem /S /P /P 197 0 R /E (Pancreatic tumor is surgically removed and) /Pg 8 0 R /K [9] >> endobj 86 0 obj << /Type /StructElem /S /P /P 198 0 R /E <50617469656E7420686173207265636569766564206D756C74696D6F64616C207468657261707920286E656F61646A7576616E742C2073616E6477696368206F722061646A7576616E74206368656D6F7468657261707920B120726164696174696F6E29206F72> /Pg 8 0 R /K [10] >> endobj 87 0 obj << /Type /StructElem /S /P /P 199 0 R /E (Patient is ineligible for or refuses multimodal therapy) /Pg 8 0 R /K [11] >> endobj 88 0 obj << /Type /StructElem /S /P /P 200 0 R /E (Patient has one of the following:) /Pg 8 0 R /K [12] >> endobj 89 0 obj << /Type /StructElem /S /P /P 201 0 R /E (Post-surgical cancer antigen \(CA\) 19-9 elevation \(> 35 U/mL at least 6 weeks post-surgical resection\) in the setting of bilirubin < 2 mg/dL \(unless bilirubin elevation is consistent with Gilbert's syndrome\) OR) /Pg 8 0 R /K [13] >> endobj 90 0 obj << /Type /StructElem /S /P /P 202 0 R /E (High-risk pathological features, defined as positive surgical margin or lymph node involvement in cancer.) /Pg 8 0 R /K [14] >> endobj 91 0 obj << /Type /StructElem /S /P /P 203 0 R /E (Patient has no definitive measurable disease recurrence or metastatic disease at the time of first post-surgical imaging \(in those with high-risk pathological features\) or within four weeks of elevated CA 19-9 value as evidenced by appropriate imaging) /Pg 8 0 R /K [15] >> endobj 92 0 obj << /Type /StructElem /S /P /P 204 0 R /E (Laboratory values:) /Pg 8 0 R /K [16] >> endobj 93 0 obj << /Type /StructElem /S /P /P 205 0 R /E /Pg 8 0 R /K [17] >> endobj 94 0 obj << /Type /StructElem /S /P /P 206 0 R /E /Pg 8 0 R /K [18] >> endobj 95 0 obj << /Type /StructElem /S /P /P 207 0 R /E /Pg 8 0 R /K [19] >> endobj 96 0 obj << /Type /StructElem /S /P /P 208 0 R /E /Pg 8 0 R /K [20] >> endobj 97 0 obj << /Type /StructElem /S /P /P 209 0 R /E (ECOG Performance Status 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