New research links DNA repair gene alterations to differential efficacy of combination chemotherapies in metastatic pancreatic ductal adenocarcinoma (PDAC). The study shows that tumors with specific DNA repair mutations respond differently to established combination regimens, highlighting the need to genotype PDAC patients to inform regimen selection and trial stratification. The data offer a precision‑medicine lens for a disease historically treated with one‑size‑fits‑all cytotoxics and may prompt biomarker‑driven trial designs.