[Pancreatic adenocarcinoma: 10 years of progress]

Despite the pejorative prognosis of pancreatic adenocarcinoma, significant progress has been made during the past decade at all steps of tumour development. Sporadic preneoplastic lesions are better recognized and a case-by-case prophylactic resection can be proposed. Both the identification and the screening of relatives at risk are in development. Availability of FOLFIRINOX and gemcitabine plus nab-paclitaxel combinations has stopped the long period of failures with gemcitabine doublets. Improvement in chemotherapy may benefit to borderline and locally-advanced forms of this cancer. They are now better evaluated by imaging and often, induction chemotherapy is proposed that allows to achieve a tumor control and then better select patients eligible for surgery in order to avoid unuseful/incomplete resection. The role of radiation therapy and other emerging local treatments merits further assessment. More robust data are needed for prognostic and predictive biomarkers to help in the choice of treatments. Finally, intensification of supportive care and shortened delay to access the treatment should be a major goal to improve the management of this disease.