[Up-to-date diagnosis and treatment of advanced pancreatic cancer]

The majority of pancreatic cancer patients are inoperable at time of diagnosis. For locally inoperable or metastatic disease, the standard therapy remains palliative chemotherapy with Gemcitabine, as so far no other therapy has been shown to be clearly superior. With numerous patients still in a good physical condition at time of progression under Gemcitabine therapy, secondline therapies get into the focus of interest. For the first time, superiority of a secondline therapy compared to best supportive care was demonstrated recently, and more phase III studies are to come. For locally advanced cases, chemoradiation may form another approach and is being discussed. Due to the high percentage of disease recurrence after curative surgery, adjuvant chemotherapy should be offered to all patients. Treatment of pain, malabsorption and maldigestion is an important issue of supportive therapy in pancreatic cancer patients.