Table 5.

Priorities for pancreatic cancer: medical oncology in advanced/metastatic disease

High priority	Medium priority	Low priority
First line chemotherapy in patients fit for a combined regimen likely to improve survival and quality of life outcomes in metastatic disease	In case of asymptomatic or pauci-symptomatic elderly patients consider with caution the risk/benefit ratio derived from monotherapy treatment	Follow-up imaging and restaging studies in asymptomatic patients
Continuation of treatment in the context of a clinical trial	Consider with caution starting or prosecution of second line treatment according to the patient’s condition	Antiresorptive therapy (zoledronic acid, denosumab) that is not needed urgently for hypercalcaemia