胰腺导管腺癌（PDAC）因早期诊断困难，多数病人确诊时已进展至局部晚期或转移阶段，系统性治疗成为改善生存的关键。为弥合亚洲各国指南差异并回应区域临床实践需求，亚太地区14位权威专家基于德尔菲法形成《胰腺导管腺癌系统治疗亚洲专家共识》。共识围绕14条核心推荐（R1-R14），按疾病分期提出分层管理策略。对于可切除PDAC，辅助治疗首选改良FOLFIRINOX（mFOLFIRINOX），体力状况较差者可选用吉西他滨联合卡培他滨、S-1单药等方案。临界可切除PDAC病人推荐新辅助治疗，首选GnP或FOLFIRINOX。局部进展期PDAC病人根据体力状况选择联合或单药化疗。转移性PDAC病人一线推荐GnP、NALIRIFOX或mFOLFIRINOX，二线强调交叉使用吉西他滨与5-FU为基础方案。该共识首次为亚洲PDAC系统治疗提供综合、标准化管理框架，旨在提升区域诊疗同质化与病人结局。本文对共识内容进行解读，以期指导临床实践。

Pancreatic ductal adenocarcinoma (PDAC) is difficult to diagnose in its early stages. Most patients are diagnosed at a locally advanced or metastatic stage. Systemic therapy has become the key to improve survival. To bridge the differences in guidelines across Asian countries and address regional clinical practice needs, 14 leading experts in the Asia-Pacific region developed the “Asian Consensus on systemic therapy for pancreatic ductal adenocarcinoma” on the Delphi method. The consensus centers on 14 core recommendations (R1-R14) and proposes stratified management strategies based on disease stage. For resectable PDAC, adjuvant modified FOLFIRINOX (mFOLFIRINOX) is the preferred option, while for the patients with poor performance status gemcitabine plus capecitabine, S-1 monotherapy, and other regimens can be selected. For borderline resectable PDAC, neoadjuvant therapy is recommended, with GnP or FOLFIRINOX as the preferred regimens. For locally advanced PDAC, combination or monochemotherapy is selected based on their performance status. For metastatic PDAC, first-line options include GnP, NALIRIFOX, or mFOLFIRINOX, with second-line therapy the cross-use of gemcitabine-based and 5-FU-based regimens are emphasized. This consensus provides for the first time a comprehensive and standardized management framework for systemic therapy of PDAC in Asia, aiming to enhance regional homogeneity in clinical practice and improve patient outcomes. This article interpreted the consensus content with the goal of guiding clinical practice.