Consensus statement on the use of systemic therapies in pancreatic ductal adenocarcinoma in Asia

Systemic therapies, primarily cytotoxic chemotherapies, are the mainstay treatment option for pancreatic ductal adenocarcinoma (PDAC) alongside surgery. Several guidelines exist for managing PDAC within Asia, but recommendations for systemic therapies can differ significantly. Consequently, geograph...

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Main Authors: D.-Y. Oh, B. Shen, S. Satoi, J. Zhou, K.-P. Kim, S.P. Choo, S.M. Woo, S.L. Chan, L. Shen, M. Ikeda
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:ESMO Gastrointestinal Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2949819825000275
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author D.-Y. Oh
B. Shen
S. Satoi
J. Zhou
K.-P. Kim
S.P. Choo
S.M. Woo
S.L. Chan
L. Shen
M. Ikeda
author_facet D.-Y. Oh
B. Shen
S. Satoi
J. Zhou
K.-P. Kim
S.P. Choo
S.M. Woo
S.L. Chan
L. Shen
M. Ikeda
author_sort D.-Y. Oh
collection DOAJ
description Systemic therapies, primarily cytotoxic chemotherapies, are the mainstay treatment option for pancreatic ductal adenocarcinoma (PDAC) alongside surgery. Several guidelines exist for managing PDAC within Asia, but recommendations for systemic therapies can differ significantly. Consequently, geographical areas across Asia not covered by international or regional guidelines often have disparate care for PDAC patients. To address this, we utilised the Delphi method to establish a collective opinion on the optimal use of systemic therapies for PDAC patients in Asia. Fourteen comprehensive consensus recommendations are reported. For resectable/localised and borderline resectable disease, recommendations were developed on specific chemotherapeutic regimens for adjuvant and neoadjuvant settings and best practice monitoring. Recommendations on downstaging/conversion therapy and therapy options were developed for locally advanced disease. In metastatic disease, recommendations for first- and second-line therapy options were developed, covering overall treatment strategy and best supportive care. In addition, consensus recommendations for molecular and genomic testing in PDAC were developed. To our knowledge, we report the first consensus statement on the optimal use of systemic therapies in PDAC for a broad, cross-border Asian population. These expert recommendations may serve as a starting point to improve the standardisation of treatment practices and care for PDAC patients within Asia.
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spelling doaj-art-dffa9e1b94e2476982ddbc9b37650ce52025-08-20T02:07:23ZengElsevierESMO Gastrointestinal Oncology2949-81982025-06-01810015810.1016/j.esmogo.2025.100158Consensus statement on the use of systemic therapies in pancreatic ductal adenocarcinoma in AsiaD.-Y. Oh0B. Shen1S. Satoi2J. Zhou3K.-P. Kim4S.P. Choo5S.M. Woo6S.L. Chan7L. Shen8M. Ikeda9Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of KoreaDepartment of General Surgery, Pancreatic Disease Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of ChinaDepartment of Surgery, Kansai Medical University, Hirakata, Japan; Division of Surgical Oncology, University of Colorado Anschutz Medical Campus, Aurora, USAState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, Beijing, People's Republic of ChinaDepartment of Oncology, Asan Medical Center/University of Ulsan, Seoul, Republic of KoreaDivision of Medical Oncology, National Cancer Centre Singapore, Singapore; Curie Oncology, Singapore, SingaporeResearch Institute, National Cancer Center, Goyang, Republic of KoreaState Key Laboratory of Translational Oncology, Department of Clinical Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, People's Republic of China; Correspondence to: Prof. Stephen Lam Chan, Department of Clinical Oncology, Prince of Wales Hospital, 330-32 Ngan Shing Street, Shatin N.T., Hong Kong, People’s Republic of China. Tel: +852 35052166State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China; Prof. Lin Shen, State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, People’s Republic of China. Tel: +86-10-88196561Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan; Prof. Masafumi Ikeda, Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. Tel: +81-90-1466-8557Systemic therapies, primarily cytotoxic chemotherapies, are the mainstay treatment option for pancreatic ductal adenocarcinoma (PDAC) alongside surgery. Several guidelines exist for managing PDAC within Asia, but recommendations for systemic therapies can differ significantly. Consequently, geographical areas across Asia not covered by international or regional guidelines often have disparate care for PDAC patients. To address this, we utilised the Delphi method to establish a collective opinion on the optimal use of systemic therapies for PDAC patients in Asia. Fourteen comprehensive consensus recommendations are reported. For resectable/localised and borderline resectable disease, recommendations were developed on specific chemotherapeutic regimens for adjuvant and neoadjuvant settings and best practice monitoring. Recommendations on downstaging/conversion therapy and therapy options were developed for locally advanced disease. In metastatic disease, recommendations for first- and second-line therapy options were developed, covering overall treatment strategy and best supportive care. In addition, consensus recommendations for molecular and genomic testing in PDAC were developed. To our knowledge, we report the first consensus statement on the optimal use of systemic therapies in PDAC for a broad, cross-border Asian population. These expert recommendations may serve as a starting point to improve the standardisation of treatment practices and care for PDAC patients within Asia.http://www.sciencedirect.com/science/article/pii/S2949819825000275pancreatic cancerpancreatic ductal adenocarcinomasystemic therapiesexpert consensusDelphi methodAsia
spellingShingle D.-Y. Oh
B. Shen
S. Satoi
J. Zhou
K.-P. Kim
S.P. Choo
S.M. Woo
S.L. Chan
L. Shen
M. Ikeda
Consensus statement on the use of systemic therapies in pancreatic ductal adenocarcinoma in Asia
ESMO Gastrointestinal Oncology
pancreatic cancer
pancreatic ductal adenocarcinoma
systemic therapies
expert consensus
Delphi method
Asia
title Consensus statement on the use of systemic therapies in pancreatic ductal adenocarcinoma in Asia
title_full Consensus statement on the use of systemic therapies in pancreatic ductal adenocarcinoma in Asia
title_fullStr Consensus statement on the use of systemic therapies in pancreatic ductal adenocarcinoma in Asia
title_full_unstemmed Consensus statement on the use of systemic therapies in pancreatic ductal adenocarcinoma in Asia
title_short Consensus statement on the use of systemic therapies in pancreatic ductal adenocarcinoma in Asia
title_sort consensus statement on the use of systemic therapies in pancreatic ductal adenocarcinoma in asia
topic pancreatic cancer
pancreatic ductal adenocarcinoma
systemic therapies
expert consensus
Delphi method
Asia
url http://www.sciencedirect.com/science/article/pii/S2949819825000275
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