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, 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.