Expert Consensus on Precision Detection and Molecular Diagnosis of Pancreatic Cancer (2025 Edition)

doi:10.3969/j.issn.1009-0460.2025.09.013

Abstract：Pancreatic ductal adenocarcinoma (PDAC) is the most common histological type of primary malignant tumor of the pancreas, accounting for approximately 95% of cases, commonly referred to as pancreatic cancer [1]. It has a very poor prognosis and its incidence is increasing [2]. According to the latest report in 2025, pancreatic cancer has ranked among the top 10 most common malignant tumors in both males and females. Its mortality rate ranks fourth among males and third among females, making it one of the most lethal malignancies [3]. Approximately 57% of patients with pancreatic cancer have already developed metastases at the time of diagnosis [1], requiring systemic treatment, with chemotherapy still being the preferred regimen for metastatic pancreatic cancer. However, the overall efficacy of existing systemic treatment regimens is low, and the 5-year survival rate for patients with metastatic disease remains below 5% [3]. Although the majority of pancreatic cancers have common driver genes, they still exhibit significant heterogeneity at the molecular level. Through whole-genome sequencing and analysis of pancreatic cancer, previous studies have proposed molecular subtypes with potential clinical application value [4-5]. With the popularization of the concept of precision medicine, the CSCO (Chinese Society of Clinical Oncology) guidelines for the clinical diagnosis and treatment of pancreatic cancer recommend, based on Level I evidence, gene testing and other molecular tests on tissue or cell samples to guide patients in receiving targeted therapy or immunotherapy and other personalized precision treatment plans [6]. To further promote the application of gene testing and molecular testing in the precision treatment of pancreatic cancer, the CSCO Pancreatic Cancer Expert Committee has gathered expert wisdom to jointly draft the 'Expert Consensus on Precision Detection and Molecular Diagnosis of Pancreatic Cancer', aiming to provide clinical physicians with authoritative references for precision treatment.