Metastatic pancreatic ductal adenocarcinoma (mPDAC) is notoriously aggressive with a poor prognosis. It is often diagnosed late, and by this time, surgery is usually not an option. Median overall survival without treatment is just a few months but with systemic chemotherapy this can be improved.    This video includes the highlights from a video podcast where medical oncologists Prof Shubham Pant and Prof Efrat Dotan discuss how to choose and optimise the different chemotherapeutic options at first and second line.  Key clinical takeaways:  mPDAC is notoriously aggressive with a poor prognosis. Patients are generally diagnosed with advanced stage disease and require treatment with chemotherapy as soon as possible  Frontline regimens should be individualised based on ECOG status, comorbidities, and risk of neuropathy; FOLFIRINOX, NALIRIFOX, and gemcitabine/nab-paclitaxel all offer survival benefit with distinct toxicity profiles  Choice of second-line treatment should be guided by prior regimen and patient fitness   Dose modification and alternative scheduling are standard in real-world practice and are used to maintain dose intensity while improving tolerability and reducing adverse events  You can also watch a video of the experts in conversation and download the accompanying transcript on our website: https://cor2ed.com/gi-connect/programmes/tackling-mpdac/?media=0  Or watch on YouTube: https://youtu.be/8YxRnjOYUv4  Follow us on social media:  LinkedIn: https://www.linkedin.com/company/giconnect  X: https://x.com/giconnectInfo  This content is intended for healthcare professionals only.  The medical experts in this podcast are expressing their own views and not those of COR2ED, Supporters or their institution.  This podcast is supported by an Independent Education Grant from Ipsen USA.  This podcast is developed by cor2ed.com  Published May 2025  Subscribe to this channel to stay up to date with new Independent Education programmes as they’re released.