 In patients with excellent general condition complying with further prerequisits age 75 years, total serum bilirubin 1,5xULN, no history of cardiovascular diseases the French Prodige study-group could show a statistical superiority for the gemcitabine-free FOLFIRINOX-scheme in terms of overall survival, progression free survival and response rate compared to gemcitabine alone. However, this superiority was gained at the expense of treatment tolerability. During treatment with FOLFIRINOX a grade 3-4 neutropenia was observed in 5.4 and a grade 3-4 diarrhea in 12.7 of patients Conroy et al. 2011. For patients who comply with the above-named criteria FOLFIRINOX is considered an established standard of care. 