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Systemic Therapy for Advanced Pancreatic Cancer in 2025: Current Standard-of-Care and Emerging Therapeutic Strategies

Gerry Gin Wai Kwok1, Jenny Lo1, Tiffany Hoi Wing Fung1

  • 1Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong.

Journal of Gastroenterology and Hepatology
|March 25, 2026
PubMed

Insights

Advanced pancreatic cancer treatment is improving with new targeted therapies and biomarker strategies. Precision medicine, including next-generation sequencing, offers personalized options and hope for better survival rates.

Area of Science:

  • Oncology
  • Genomics
  • Precision Medicine

Background:

  • Pancreatic cancer is a leading cause of cancer death with limited therapeutic progress.
  • Current systemic therapies offer modest benefits for advanced disease.

Purpose of the Study:

  • To review recent advances in first-line standard of care for pancreatic cancer.
  • To explore biomarker-driven strategies and novel therapeutic targets for personalized treatment.

Main Methods:

  • Literature review of recent clinical trials and research.
  • Analysis of biomarker-driven approaches, including next-generation sequencing.
  • Evaluation of emerging therapeutic modalities and targets.

Main Results:

  • Next-generation sequencing facilitates precision therapy, identifying targets like NRG1 fusions and BRAF alterations.
  • New treatments include KRAS inhibitors, PROTACs, tumor treating fields, and PRMT5 inhibitors.
  • Emerging immunotherapies targeting Claudin18.2 and CXCR4 show promise against tumor resistance.

Conclusions:

  • Molecular stratification and synthetic lethality are key to improving pancreatic cancer survival.
  • Personalized treatment selection based on biomarkers is transforming patient care.
  • Novel targets and therapies offer significant hope for overcoming treatment resistance.
Keywords:
CAR‐TCXCR4ESCATKRASMTAPNRG1PDACPRMT5PROTACpancreatic cancer

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