Background: Treating metastatic pancreatic cancer (MPC) remains a challenging issue. Significant improvement was achieved recently by combining 4 drugs with Folfirinox regimen at the cost of increased toxicities compared to Gemcitabine. Maintenance therapy is a growing concept used in many different types of cancer. Our retrospective analysis aims to evaluate effectiveness and tolerability of early maintenance capecitabine administrated to patients with MPC treated with first line Folfirinox. Methods: 103 patients treated for MPC between November 2009 and July 2014 were retrospectively identified. Among them, 31 patients initially treated with a minimum of 4 cycles of Folfirinox, without sign of progression, received maintenance therapy with capecitabine until progression. Upon first progression (PFS1), patients were retreated with Folfirinox until second progression (PFS2). Survival was estimated with Kaplan Meier method. Results: Median numbers of cycles achieved for Folfirinox and capecitabine were respectively 6 and 4.5. Initial median dose of capecitabine was 2000mg/m², we recorded dose reduction in 11 cases (35,4%), mostly due to cutaneous and digestive toxicities. Median overall survival (OS) was 19 months. Survival rates were 74% at 1 year (95% CI [0.59 to 0.91]) and 24% at 2 years (95% CI [0.12 to 0.47]). Median PFS1 was 11 months (95% CI [0.22 to 0.58]). 30 patients have relapsed during capecitabine treatment (96,7%). After disease progression, Folfirinox could be reintroduced in 14 cases. Other patients received FOLFIRI, Gemcitabine and Folfox due mainly to persistence of neuropathy and asthenia. Median PFS 2 was 16 months (95% CI [0.22 to 0.65]). Conclusions: Maintenance with capecitabine seems effective and safe without compromising Folfirinox efficacy and allows obtaining very promising overall and progression free survival. Role of maintenance therapy in MPC will soon be addressed in a French multicenter phaseII/III study. PANOPTIMOX/PRODIGE 35.