Penpulimab Combined With Anlotinib and Nab-paclitaxel Plus Gemcitabine as First-line Treatment for Advanced Metastatic Pancreatic Cancer

This study tests a four-drug combination as the first treatment for advanced metastatic pancreatic cancer: two chemotherapy drugs (nab-paclitaxel and gemcitabine), a targeted drug (anlotinib), and an immunotherapy drug (penpulimab). Researchers hope this combination will improve survival compared to standard two-drug chemotherapy. **You may be eligible if...** - You are 18 or older and have been diagnosed with metastatic pancreatic cancer confirmed by biopsy - You have at least one tumor that can be measured on a scan - You have never received systemic cancer treatment before - Your blood counts and organ function are within acceptable ranges - Your overall health is adequate and life expectancy is more than 3 months **You may NOT be eligible if...** - You have received prior systemic chemotherapy or other cancer treatments - You have significant heart, liver, kidney problems, or active infections - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.