Modified FOLFIRINOX versus S-1 as second-line chemotherapy in gemcitabine-failed metastatic pancreatic cancer patients: A randomised controlled trial (MPACA-3)

•mPAC patients with good PS refractory to gemcitabine-based therapy were enrolled.•Compared with S-1, mFOLFIRINOX significantly prolonged OS and PFS.•ORR and DCR were higher in the mFOLFIRINOX group than in the S-1 group.•Grade 3–4 toxicities were more common in the mFOLFIRINOX group than in the S-1 group.