FOLFIRINOX + Elraglusib + Losartan In Pancreatic Cancer

Inclusion Criteria: * Histologically confirmed metastatic pancreatic adenocarcinoma without prior therapy for pancreatic adenocarcinoma. * Participants must have measurable disease as defined by RECIST 1.1 * Age ≥18 years. * ECOG performance status ≤1 (Karnofsky ≥ 70%, see Appendix A). * Participants must have adequate organ and marrow function as defined below: * Absolute neutrophil count (ANC) ≥ 1,500/mcL * Platelets ≥ 100,000/mcL * Total bilirubin ≤ 1.5 institutional upper limit of normal (ULN) if no biliary stenting has been done OR 2.0 x ULN if patient is status post biliary stenting or two downward trending values. * AST(SGOT)/ALT(SGPT) \< 5 x institutional ULN. * Creatinine ≤ 1.5 mg/dL OR . * Creatinine clearance ≥ 30 mL/min (as estimated by Cockcroft Gault Equation) (140 - age \[yrs\]) (body wt \[kg\]) Creatinine clearance for males = ------------ (72) (serum creatinine \[mg/dL\]) * Creatinine clearance for females = 0.85 x male value * Prior treatment with angiotensin receptor blocker (ARB) for hypertension is allowed. If the patient is randomized to a non-losartan containing treatment arm, the patient must be changed to an antihypertensive medication that is not in the class of angiotensin receptor blocker (ARB). * Human immunodeficiency virus (HIV)-infected participants on effective anti-retroviral therapy within 6 months are eligible for this trial. * Participants with evidence of chronic hepatitis B virus (HBV) infection on suppressive therap…