Revision of Clinical Practice Guidelines for Pancreatic Cancer 2022 -precision medicine group-

Abstract

In the Clinical Practice Guidelines for Pancreatic Cancer 2022 from the Japan Pancreas Society, a new "Precision Medicine Group" was established and Clinical Questions and statements were developed for diagnosis (D4~D8) and treatment (LC4/MC4). As for assessing the risk of cancer development in individuals without cancer, from the disease entity of familial pancreatic cancer, research on cancer predisposition genes or surveillance has been ongoing and germline genetic testing is weakly recommended (D6). As for finding effective treatments based on genetic information, a pivotal phase III study (POLO trial) indicated that olaparib as maintenance therapy after treatment with a platinum regimen prolongs progression-free survival in patients harboring germline BRCA1/2 pathogenic variants (D6, LC4/MC4). In addition, various cancer genetic panel tests have been recently implemented clinically (D5, D5L) and each situation will lead to increased chances of detecting secondary findings of germline pathogenic variants (D7/D8), and development of infrastructure. Although the evidence for these statements is currently insufficient and all are weak recommendations, this is an area with an extremely strong societal need.