Pancreatic cancer is characterized by cellular heterogeneity, contributing to variable responses to anticancer treatment. Natural products may modify these responses in a context-dependent manner. We investigated whether three Lepidium meyenii Walp. (Brassicaceae; maca) preparations, marked as yellow (MY), red (MR), and black (MB), differentially modify pancreatic cancer cell responses to doxorubicin (DOX). BxPC-3, MIA PaCa-2, and PANC-1 cells were treated with maca preparations alone or combined with DOX. Cell viability, apoptosis-associated signaling, survival-related proteins, lipid droplet accumulation, and lipid metabolism-related proteins were evaluated. Drug interactions were assessed using Bliss independence and Highest Single Agent (HSA) models. Interaction profiles differed among cell lines and depended on the tested maca preparation and DOX concentration. The strongest favorable interactions were observed in PANC-1 cells treated with MR or MB plus 2.5 µM DOX (Bliss/HSA scores: 18.9/13.1 and 17.6/12.4, respectively), whereas BxPC-3 cells showed favorable interactions with MY, MR, and MB at 5 µM DOX (Bliss/HSA scores: 12.4/9.8, 10.7/8.5, and 11.9/9.2, respectively). MIA PaCa-2 cells showed mainly neutral or less-than-additive interactions. These responses were accompanied by changes in caspase-3 activation, PI3K, FAP, and FOXO1 protein levels, lipid droplet accumulation, and ATGL, ABHD5, and PLIN3 levels. Overall, the tested MY, MR, and MB preparations differentially modified pancreatic cancer cell responses to DOX and were associated with distinct survival-related and lipid metabolism-related changes. Further phytochemical characterization and functional mechanistic studies are required to identify the constituents involved and determine whether the observed molecular changes contribute causally to these effects.