Metastatic cancer is cancer that has spread, through the bloodstream or lymphatic system, from the place where it first started to another place in the body. The ability of a cancer cell to metastasize depends on its individual properties; the properties of the noncancerous cells, including immune system cells, present at the original location; and the properties of the cells it encounters in the lymphatic system or the bloodstream and at the final destination in another part of the body. Pancreatic ductal adenocarcinoma most frequently metastasizes to the liver, distant lymph nodes, the peritoneum and the lung (stage IV). 

Standard medical treatment for metastatic pancreatic ductal adenocarcinoma typically involves chemotherapy. There appear to be interesting and potentially promising combinations of several two or more conventional medical treatment drug agents which are in practice and under study for the treatment of metastatic pancreatic ductal adenocarcinoma, such as 5-fluorouracil, irinotecan and oxaliplatin (FOLFIRINOX regimen). Additionally, there is a wide range of single-mode medical treatment approaches currently in clinical trials against pancreatic adenocarcinoma. These include some of the newer experimental therapies which are aimed more at molecular targets and at interrupting genetic signaling pathways, newer chemotherapy drug agents, and even vaccines against cancer.

Individualized medical treatment regimens as tailored by expert oncologists involving single agents or combination therapy for metastatic pancreatic ductal adenocarcinoma may prolong survival and quality of life. And finally, clinical trials remain an option.