For a solitary liver met of pancreatobiliary origin with neoadjuvant chemotherapy required for preoperative downstaging, would you recommend mFOLFIRINOX or Gem-Cis?  

It depends on the patient’s performance status. If the patient can handle the three drug regimen,  then I would attempt it. I would offer a very quick surveillance scan after 4 to 6 weeks to see if there’s a response. If not, would consider switching. NGS panel may also be considere...