Stage 4 pancreatic cancer treatment decisions require understanding how chemotherapy regimens, biomarker testing, performance status, and supportive care work together to extend life and maintain quality of life when cancer has spread beyond the pancreas. TL;DR Only 15-20% of pancreatic cancer patients have potentially resectable disease at diagnosis, making stage 4 treatment planning critical for the majority [1] FOLFIRINOX demonstrates median overall survival of 11.1 months