Pancreatic cancer
Risk factors and who to survey, painless jaundice and new diabetes, pancreatic-protocol CT and resectability, CA 19-9 traps, adjuvant and neoadjuvant chemotherapy, metastatic regimens including the 2026 RAS inhibitor update, and supportive care.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- About 4,500 Australians a year are diagnosed. Five-year survival is about 12%, the lowest of the common cancers.
- Over 90% are pancreatic ductal adenocarcinoma (PDAC), and about 90% carry a KRAS mutation (most often G12D).
- Painless obstructive jaundice suggests a head tumour; body and tail cancers present late with pain and weight loss.
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Sources
- Optimal care pathway for people with pancreatic cancer (2nd edition)AU/NZCancer Council Victoria and Department of Health Victoria (endorsed nationally), 2021
- eviQ Cancer Treatments Online (pancreatic protocols)AU/NZCancer Institute NSW
- Conroy T et al. Pancreatic cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2023;34:987-1002European Society for Medical Oncology, 2023
- ESMO Clinical Practice Guideline express update on the management of metastatic pancreatic cancer (NALIRIFOX)European Society for Medical Oncology, April 2025
- Conroy T, Ducreux M. ESMO Clinical Practice Guideline express update: daraxonrasib for RAS G12-mutated metastatic pancreatic ductal adenocarcinoma. Ann Oncol 2026European Society for Medical Oncology, August 2026
- NCCN Clinical Practice Guidelines in Oncology, Pancreatic AdenocarcinomaNational Comprehensive Cancer Network
- Conroy T et al. FOLFIRINOX or gemcitabine as adjuvant therapy for pancreatic cancer (PRODIGE 24). N Engl J Med 2018;379:2395-406New England Journal of Medicine, 2018
- Wainberg ZA et al. NALIRIFOX versus nab-paclitaxel and gemcitabine in treatment-naive metastatic pancreatic ductal adenocarcinoma (NAPOLI 3). Lancet 2023;402:1272-81The Lancet, 2023
- Golan T et al. Maintenance olaparib for germline BRCA-mutated metastatic pancreatic cancer (POLO). N Engl J Med 2019;381:317-27New England Journal of Medicine, 2019
- Goggins M et al. Management of patients with increased risk for familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium. Gut 2020;69:7-17Gut, 2020
- PBAC Public Summary Document: irinotecan nanoliposomal (NALIRIFOX), first-line metastatic pancreatic cancerAU/NZPharmaceutical Benefits Advisory Committee, November 2024
- FDA approves daraxonrasib for metastatic pancreatic adenocarcinomaUS Food and Drug Administration, 26 August 2026
- MBS item 73322: DPYD genotyping before, during or after fluoropyrimidine therapyAU/NZAustralian Government Department of Health, Disability and Ageing (MBS Online), From 1 November 2025
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback