Management of Metastatic Pancreatic Cancer—Comparison of Global Guidelines over the Last 5 Years

SIMPLE SUMMARY: Pancreatic cancer (PC) is a disease with a poor prognosis due to several factors, such as late diagnosis at an advanced stage of the disease, metastases and resistance to most treatment regimens. In recent years, only a few new treatments have been developed, but not all of them are eligible to treat all of the patients. The main objective of this review is to present the advancements in treatment guidelines from recent years. ABSTRACT: Pancreatic cancer (PC) is usually diagnosed at an advanced stage of its development, which results in lower overall survival (OS). Prognosis is also poor even with curative-intent surgery. Approximately 80% of patients with localized PDAC have micrometastases at the time of diagnosis, which leads to a worse prognosis than in other cancers. The objective of this study is to present the progress in the treatment of metastatic pancreatic cancer based on the recommendations of oncological scientific societies, such as ESMO, NCCN, ASCO, NICE and SEOM, over the last 5 years. Combined FOLFIRINOX therapy is mostly a recommended therapy among patients with good performance statuses, while gemcitabine is recommended for more fragile patients as a first-line treatment. The newest guidelines suggest that molecular profiling of the tumor should be the first step in determining the course of treatment. The use of modern molecular therapies in patients with specific gene mutations should extend the survival of patients with this disease.