Pancreatic cancer is the 10th leading cause of death worldwide. It is a very lethal and aggressive tumor, with a 5-year overall survival rate under 5% for confirmed ductal adenocarcinoma. No guidelines are currently in place at the Geneva University Hospital to classify the different type of tumors and what neo-adjuvant regimen to use. We performed an extensive review of the literature of all prospective trials performed between January 2000 and January 2015 that used exclusively chemotherapy for neo-adjuvant therapy in pancreatic cancer. Furthermore we compared the response rate of the chemotherapeutic regimen Oxaliplatin, Irinotecan, Fluorouracil and Leucovorin (FOLFIRINOX) to the combination Gemcitabine- nab-Paclitaxel. Based on this review and after a multi-disciplinary evaluation, we suggest adopting the classification of the MD Anderson Cancer Center for pancreas adenocarcinoma. Tumors that are resectable or borderline resectable should be operated and patients should then receive adjuvant therapy. For patients with non-resectable tumors, according to the MD Anderson staging system, chemotherapy will be proposed and the progression/regression of the tumor will then be reevaluated. Two chemotherapeutic options have shown the highest median survival rate: the FOLFIRINOX regimen and the combination Nab-Paclitaxel plus Gemcitabine.