In a significant step towards strengthening pancreatic cancer care across Asia, Dr. Shyam Aggarwal, Chairperson of Medical Oncology at Sir Ganga Ram Hospital (SGRH), New Delhi, has represented India in the development of the Pan-Asian Adapted (PAGA) ESMO Consensus Guidelines for pancreatic cancer—an international initiative led under the aegis of the European Society of Medical Oncology (ESMO).

The guidelines have been developed by the Indian Society of Medical and Paediatric Oncology (ISMPO) in collaboration with leading oncology societies from across Asia, addressing one of the most lethal malignancies worldwide. Pancreatic cancer continues to carry a grim prognosis, largely due to late-stage diagnosis and limited access to timely, effective treatment.

Recognising the wide disparities in healthcare systems, disease patterns, and access to diagnostics and therapies across Asian countries, the PAGA ESMO guidelines adapt global ESMO recommendations to regional realities. The aim is to ensure that pancreatic cancer care remains evidence-based, practical, and feasible across diverse healthcare settings—from high-resource centres to more constrained environments.

Dr. Aggarwal played an active role in this prestigious international effort, working alongside oncology experts from Thailand, Singapore, Malaysia, Japan, Indonesia, the Philippines, South Korea, China, and Taiwan. The guidelines were formulated through a structured, questionnaire-based assessment followed by detailed scientific deliberations among experts.

The consensus document offers stage-wise and resource-stratified recommendations covering the full spectrum of pancreatic cancer care. This includes guidance on early and accurate diagnosis, appropriate patient selection for surgery and systemic therapies, and evidence-based management of resectable, borderline resectable, locally advanced, and metastatic disease. Special emphasis has also been placed on structured follow-up, supportive care, and palliative care to improve patients’ quality of life.

Designed for medical and surgical oncologists, gastroenterologists, radiologists, pathologists, multidisciplinary tumour boards, and healthcare policymakers, the PAGA ESMO guidelines seek to standardise pancreatic cancer care across Asia. By reducing treatment variability and delays, promoting cost-effective use of diagnostics and therapies, and strengthening multidisciplinary decision-making, the guidelines aim to improve outcomes at a population level.

Commenting on the initiative, Dr. Shyam Aggarwal said the Pan-Asian Adapted ESMO guidelines mark a major milestone in harmonising pancreatic cancer treatment protocols across the region. He noted that region-specific, consensus-driven recommendations have the potential to significantly improve clinical outcomes while ensuring more equitable access to quality cancer care.

Dr. Aggarwal also expressed gratitude to the Sir Ganga Ram Hospital fraternity and his oncology colleagues for their continued academic support, which enabled meaningful Indian participation in this global guideline development effort.

Published in an international peer-reviewed journal, the Pan-Asian Adapted ESMO Consensus Guidelines for pancreatic cancer are expected to serve as a key reference for clinicians and cancer programme leaders across Asia, contributing to stronger national cancer care frameworks and improved patient outcomes.