Tai D.Conroy T.Lee J.J.X.Chee C.E.Hao C.Y.Wijaya I.Aggarwal S.Ueno M.Jeung H.C.Hashim N.M.Tan Chun Bing J.Chen L.T.Korphaisarn K.Tanasanvimon S.Chou W.C.Cargullo E.Muin N.F.A.Lee M.A.Ohba A.Bondarde S.Lesmana C.R.A.Wang L.Smyth E.C.Yoshino T.Bonney G.Pentheroudakis G.Samol J.Cervantes A.Poon E.Ducreux M.Mahidol University2025-10-172025-10-172025-10-01ESMO Open Vol.10 No.10 (2025)https://repository.li.mahidol.ac.th/handle/123456789/112636The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with pancreatic cancer, published in November 2023, were adapted in December 2024, according to previously established standard methodology, to produce the Pan-Asian adapted (PAGA) ESMO consensus guidelines for the management of Asian patients with pancreatic cancer. The adapted guidelines presented in this manuscript represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with pancreatic cancer representing the oncological societies of China (CSCO), Indonesia (ISHMO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO), co-ordinated by ESMO and the Singapore Society of Oncology (SSO). The voting was based on scientific evidence and was independent of the current treatment practices, drug access restrictions and reimbursement decisions in the different regions of Asia. The latter are discussed separately in the manuscript. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with pancreatic cancer across the different countries of Asia, drawing on the evidence provided by both Western and Asian trials. Attention is drawn to the disparity in drug approvals and reimbursement strategies between the different countries.Biochemistry, Genetics and Molecular BiologyMedicineArticleSCOPUS10.1016/j.esmoop.2025.1058262-s2.0-10501820667720597029