In this randomised , multicentre , open-label , phase @ trial , patients with metastatic pancreatic adenocarcinoma , World Health Organisation ( WHO ) performance status @-@ , and bilirubin levels < @ upper limit of normal values ( ULN ) were randomised @:@ to receive as first-line treatment either FOLFIRI @ ( irinotecan , leucovorin and fluorouracil ) alternating with fixed-dose rate gemcitabine as @-month periods ( FIRGEM , arm A ) , or fixed-dose rate gemcitabine alone ( arm B ) .