The second leading cause of death in the world is cancer. Out of all the cancers diagnosed Pancreatic cancer is the most deadly of all where the survival rate of 5 years is 9% when diagnosed at an early stage and only 2% survival rate when diagnosed at an advanced stage. The first line of treatment given to the patients is gemcitabine-based therapy. Liposomal irinotecan is designed for increasing the effectiveness of anti-tumor while reducing drug-related toxicity compared to the normal (non-liposomal) formation of this topoisomerase 1 inhibitor. In combination with 5-fluorouracil and leucovorin (5-FU / LV), nal-IRI the first agent to be specifically approved for use in patients with metastatic pancreatic ductal adenocarcinoma (mPDAC) has progressed following gemcitabine-based treatment. Nal-IRI plus 5-FU / LV has shown moderate efficiency and controlled toxicity of patients with mPAC previously treated with conventional chemotherapy with irinotecan. NAPOLI 1 Study that was conducted in more than 75 cities demonstrated an increase in overall survival rate (OS), progression-free survival (PFS), and a significant decrease in Hazard Ratio (HR).