Alpha Radiation Emitters Device (DaRT) With Chemotherapy for the Treatment of Locally Advanced and Metastatic Pancreatic Cancer

Inclusion Criteria: * Histologically and/or cytologically proven newly diagnosed locally advanced inoperable pancreatic adenocarcinoma (Cohort 1) OR histologically and/or cytologically proven newly diagnosed metastatic pancreatic adenocarcinoma (Cohort 2). * Patients will start treatment with mFOLFIRINOX (up to 4 cycles) before DaRT insertion * Target lesion is technically amenable for Alpha DaRT sources implantation. * Measurable lesion per RECIST (version 1.1) criteria * Lesion size ≤ 5 cm in the longest diameter * Interstitial radiation indication validated by a multidisciplinary team. * ECOG Performance Status Scale 0 -2 * Life expectancy is more than 6 months * WBC ≥ 3500/μl, granulocyte ≥ 1500/μl * Platelet count ≥60,000/μl * Creatinine ≤1.9 mg/dL * AST and ALT ≤ 2.5 X upper limit of normal (ULN) * INR \< 1.4 for patients not on Warfarin * Age ≥18 years old * Subjects are willing and able to sign an informed consent form * Women of childbearing potential (WOCBP) will have evidence of negative pregnancy test before the Ra-224 implantation and are required to use an acceptable contraceptive method to prevent pregnancy for 3 months after initiation of Alpha DaRT therapy. * Patients must agree to use adequate contraception (vasectomy or barrier method of birth control) prior to study entry, for the duration of study participation and for 3 months after DaRT insertion. Exclusion Criteria: * For Cohort 1 only: Borderline unresectable pancreatic cancer, and/or fit for surgi…