This is a multi-center, open-label， randomized controlled Phase II clinical study to observe and evaluate the efficacy and safety of Penpulimab combined with Anlotinib and Nab-paclitaxel plus Gemcitabine (PAAG ) versus AG first-line treatment in patients with metastatic pancreatic cancer.
Ages ≥18 years，ECOG ≤ 2，Estimated survival time > 3 months
Histologically or Cytologically confirmed metastatic pancreatic adenocarcinoma
Based on Response Evaluation Criteria In Solid Tumors (RECIST1.1), there should be at least one measurable lesion
Patients have never received systematical anti-cancer therapy
Patients have ever received any systematical anti-cancer therapy in the past
Patients who participated in other clinical trials in the past 4 weeks
According to the investigator, patients who surgically available or potentially treatable(Patients who voluntarily give up surgical treatment can be enrolled after evaluation by the investigator)
Patients with moderate ascites requiring drainage