SWOG S1505 directly compared two modern neoadjuvant chemotherapy strategies—modified FOLFIRINOX and gemcitabine plus nab-paclitaxel—in patients with resectable pancreatic adenocarcinoma. The study was designed to ask which regimen could be delivered effectively before surgery and how this would influence surgical outcomes. Among patients who proceeded to exploration and resection, high-quality operations with R0 resection were achievable after preoperative treatment. The study also showed that not every enrolled patient ultimately reached surgery, underscoring a key practical issue in neoadjuvant pancreatic cancer care: the intended treatment pathway can be disrupted by disease progression, toxicity or loss of fitness. For surgeons, this trial reinforces the need to think about the “window for surgery.” Preoperative systemic therapy may help treat micrometastatic disease earlier, but the multidisciplinary team must continuously reassess resectability, treatment tolerance, nutrition and performance status. The study therefore supports neoadjuvant therapy as a feasible component of care in selected resectable pancreatic cancer, while emphasizing that successful outcomes depend on close coordination among medical oncology, surgery, radiology and perioperative teams. The ultimate goal is not simply to complete chemotherapy, but to reach a well-planned oncological resection in patients most likely to benefit.