Stage 4 pancreatic cancer, also called metastatic pancreatic cancer, means the disease has spread beyond the pancreas to distant organs such as the liver, lungs, or peritoneum [1]. Key Takeaways Stage 4 pancreatic cancer treatment focuses on systemic therapy, chemotherapy, targeted therapy, or immunotherapy, combined with supportive care to slow disease progression, manage symptoms, and maintain quality of life rather than cure [2]. FOLFIRINOX and gemcitabine plus nab-paclita