Stage 4 pancreatic cancer requires a multifaceted approach combining systemic chemotherapy, biomarker-driven targeted therapy, and integrated palliative care to extend survival and maintain quality of life. Treatment decisions depend on performance status, tumor genetics, organ function, and patient goals, balancing aggressive regimens with gentler options tailored to individual circumstances. Key Takeaways FOLFIRINOX offers superior response rates for fit patients with ECOG

Stage 4 pancreatic cancer has spread to distant organs, eliminating surgical options and shifting treatment focus to systemic chemotherapy combined with pain management and supportive care[8]. This guide examines evidence-based chemotherapy regimens, integrated supportive care approaches, realistic survival expectations, and transparent India-specific cost breakdowns to help patients and families make informed treatment decisions. Key Takeaways Systemic chemotherapy, FOLFIRIN