The study focuses on advanced metastatic pancreatic cancer, testing a combination of low-dose anti-cancer drugs (G-FLIP: Gemcitabine, Fluorouracil, Leucovorin, Irinotecan, and Oxaliplatin) with the addition of Mitomycin C. The aim is to find a safer and more effective therapy for this devastating disease.

Objective: Evaluate the safety, tolerability, and efficacy of G-FLIP combined with Mitomycin C for advanced pancreatic cancer.

Design: Open-label study with 60 evaluable subjects. Treatments: G-FLIP administered every 2 weeks, with Mitomycin administered every 4 weeks.

Efficacy Assessments: Based on response criteria (Complete Response, Partial Response, Stable Disease, Progressive Disease), Response Rate, Progression-Free-Survival, Overall Survival, and 12-Month Survival Rate.

Safety Assessments: Include physical exams, symptom evaluation, vital signs, ECOG performance status, clinical pathology, urinalysis, and Quality of Life assessments.

Inclusion Criteria:

• Histologically confirmed metastatic (Stage IV) pancreatic adenocarcinoma.

  • Failed first-line chemotherapy.
  • ECOG performance status of 0-2.
  • Expected survival of more than 3 months.
  • Adequate organ function as indicated by lab values.
  • Age 18 or older.
  • Signed informed consent.

Exclusion Criteria:

• • Known brain metastases.

  • Significant cardiovascular or other uncontrolled diseases.
  • Pregnant or breastfeeding women