A Phase Ib/II Randomized Study of Modified FOLFIRINOX + Pegylated Recombinant Human Hyaluronidase (PEGPH20) versus Modified FOLFIRINOX Alone in Patients with Good Performance Status Metastatic Pancreatic Adenocarcinoma

Newly diagnosed, untreated metastatic histologically or cytologically documented pancreatic adenocarcinoma with no known history of brain metastases; Measurable metastatic disease; No prior treatment with oxaliplatin or irinotecan within 3 years prior to registration. No prior chemotherapy in metastatic setting. No Prior abdominal radiation therapy; Zubrod PS 0-1; must be >/= 18 and </= 75 years of age; ANC >/= 1,500/uL; Platelets >/= 100,000/uL; Hemoglobin >/= 9 g/dL; Total bilirubin </= IULN; AST </= 2.5 x IULN; ALT </= 2.5 X IULN; or AST & ALT both </= 5.0 IULN in with liver metastasis; Serum albumin >/= 3 g/dL; Serum creatinine </= ULN or calculated creatinine clearance > 50 ml/min; INR </= 1.2; must not be receiving warfarin for therapeutic use, history of cerebrovascular accidnet, history of TIA requiring intervention or treatment, pre-existing carotid artery disease requiring intervention or treatment, or current use of megestrol acetate; Not receiving chronic treatment with systemic steroids or other immuno-suppressive agent; Not have liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis; Not have active bleeding or a pathological condition that is associated with a high risk of bleeding; Must be on active treatment for HIV; No non-malignant medical illnesses that are uncontrolled or whose control may be jeopardized by the treatment; No other prior malignancy is allowed except for: adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated Stage I or II cancer from which patient is is complete remission, or any other cancer from which the patient has been disease free for five years; Must not be pregnant or nursing; Tumor (paraffin block or slides) available for submission and willing to submit blood samples