Pancreatic cancer - systemic treatment

Pancreatic cancer is a disease with the worst long-term survival across all stages. In clinical practice, due to asymptomatic or non-specific signs and symptoms we diagnose patients mainly with locally advanced and metastatic disease, where median survival is approximately one year. However, cases of an early local recurrence or distant metastases are observed even in early stages after curative surgery, and long-term survival is an exception even in these early stages of the disease. Despite these adverse characteristics, an improvement in median overall survival has been observed also in patients with pancreatic cancer, particularly in the last few years. It is due to advancements in the diagnosis, surgery, but mainly due to improvements in cancer treatment (chemotherapy - adjuvant, neoadjuvant, perioperative, induction and palliative, and radiotherapy). The results of many studies across all stages (resectable, borderline resectable, locally advanced, metastatic) have been published, showing an improved survival. The aim of this article is to provide a review of current treatment options for pancreatic ductal adenocarcinoma.