There is currently no standard second-line therapy for advanced pancreatic cancer. With the increasing use of FOLFIRINOX in the first-line setting, there is considerable interest in the use of gemcitabine-containing regimens for patients who progress on this treatment. We have conducted a retrospective study on the use of a modified GTX regimen which has appreciable activity and is well tolerated. This has now become our institutional standard of care. This prospective study aims to collect further data regarding radiological response rate, toxicity and outcome in our population.