['metastatic pancreatic adenocarcinoma']
['ibrutinib', 'gemcitabine', 'nab-paclitaxel']

        Inclusion Criteria:

          1. Histologically or cytologically confirmed diagnosis of pancreatic adenocarcinoma.

          2. Stage IV disease diagnosed within 6 weeks of randomization

          3. Adequate hematologic function:

               -  Absolute neutrophil count (ANC) ≥1.5 x 109/L

               -  Platelet count ≥100 x 109/L

               -  Hemoglobin ≥9 g/dL

          4. Adequate hepatic and renal function defined as:

               -  AST and/or ALT ≤5.0 x upper limit of normal (ULN) if liver metastases, or ≤3 x
                  ULN without liver metastases

               -  Alkaline phosphatase <3.0 x ULN or ≤5.0 x ULN if liver or bone metastases present

               -  Bilirubin ≤1.5 x ULN (unless bilirubin rise is due to Gilbert's syndrome or of
                  non-hepatic origin, such as hemolysis)

               -  Estimated Creatinine Clearance ≥30 mL/min

          5. PT/INR <1.5 x ULN and PTT (aPTT) <1.5 x ULN

          6. KPS ≥70.

          7. Eastern Cooperative Oncology Group (ECOG) 0-1

        Exclusion Criteria:

          1. Prior therapies: BTK inhibitor, radiotherapy, radiotherapy in the adjuvant setting, or
             cytotoxic chemotherapy for primary disease of pancreatic adenocarcinoma.

          2. Neuroendocrine (carcinoid, islet cell) or acinar pancreatic carcinoma

          3. Known brain or leptomeningeal disease (CT or MRI scan of the brain required only in
             case of clinical suspicion of central nervous system involvement).

          4. Major surgery within 4 weeks of first dose of study drug.

          5. History of stroke or intracranial hemorrhage within 6 months prior to enrollment.

          6. Treatment with a strong cytochrome P450 (CYP) 3A inhibitor.
      