Chemotherapy With or Without IMD10 (Focused Ultrasound) in the Treatment of Borderline Resectable or Locally Advanced Pancreatic Cancer

Inclusion Criteria:

An individual must meet all the following criteria:

-1. Willing and able to understand and sign an ICF and to comply with all aspects of the protocol

* 2\. Aged between 18 and 85 years, inclusive
* 3\. Histologically or cytologically, pathologically confirmed diagnosis of PDAC.
* 4\. Classification as BRPC or LAPC according to the NCCN Guidelines (The latest Edition) by radiologic test (CT or MRI), eligible for chemotherapy regimen within 4 weeks of the screening visit
* 5\. Must have at least 1 measurable lesion per RECIST 1.1 criteria at the screening visit.
* 6\. The ECOG performance status 0 or 1
* 7\. Trial participant having laboratory values defined as:

  \-- Neutrophil count ≥ 1.5 x 109/L
  * Platelet count ≥ 100 x 109/L
  * AST and ALT ≤ 2.5 x ULN
  * Serum creatinine ≤ 1.5 x ULN
* 8\. Life expectancy is more than 12 weeks
* 9\. A female is eligible to trial participate if not pregnant, not breast feeding -and either a woman not of childbearing potential or, if a woman of childbearing potential agrees to use highly effective methods of contraception from screening to EOS
* 10\. A male trial participant with female partner(s) of childbearing potential agrees to use highly effective methods of contraception from screening to EOS

Exclusion Criteria:

An individual who meets any of the following criteria will be excluded from participating in this clinical trial:

* 1\. The presence of a cystic lesion within tumor to be treated, or at the pancreas adjacent to the treated tumor.
* 2\. Extensive scars or surgical clips observed in the region through which the ultrasound beam will pass
* 3\. Targeted tumor(s) is not clearly visible with IMD10.
* 4\. Tumor is not treatable by the working range of IMD10
* 5\. Patient has difficulty in lying in supine position.
* 6\. Known history of severe hypersensitivity to ultrasound gel or to chemotherapies (irinotecan hydrochloride, oxaliplatin, fluorouracil (5-FU) and leucovorin) used in this clinical trial
* 7\. Known, or ongoing receipt at the time of screening, of anti-tumor therapy for pancreatic cancer including chemotherapy, radiation, and/or surgery
* 8\. A cardiovascular condition at the time of the screening visit that deems trial participation inappropriate due to one or more of the following:

  * Class III or IV heart failure according to New York Heart Association (NYHA) classification

    * Acute coronary syndrome (unstable angina or myocardial infarction) within the last 24 weeks --③ Uncontrolled heart arrhythmia

      * Other clinically significant cardiovascular abnormalities as determined by the investigator
* 9\. Known history at the time of the screening visit that deems trial participation inappropriate due to one or more of the following:

  * Other uncontrolled chronic infectious diseases

    * Active autoimmune disease (e.g., rheumatoid arthritis, systemic lupus erythematosus, ulcerative colitis, Crohn's disease, multiple sclerosis, ankylosing spondylitis, etc.)

      * Congenital or acquired immunodeficiency diseases, such as cellular immunodeficiency, hypogammaglobulinemia, and hypergammaglobulinemia.

        * Clinically significant mental illness
* 10\. Known history of malignancies other than pancreatic cancer within the last 2 years
* 11\. Known history of major surgery within 4 weeks of the cycle 1 day 1 (C1D1)
* 12\. Pregnant and breastfeeding women
* 13\. Participating in another drug/device clinical trial or have participated in another drug/device clinical trial within 4 weeks of C1D1
* 14\. Trial participation in the clinical trial is deemed inappropriate at the investigator's discretion, either for ethical reasons or due to potential impact on the clinical trial's outcome