Patients with pancreatic cancer face a dismal prognosis. Treatments involving surgery and chemotherapy can extend overall survival, but there is a clear need for improvement of treatment and clinical outcomes.

The Dutch Pancreatic Cancer Project (PACAP) was initiated in 2013 with the aim to improve outcomes and quality of life for patients in all stages of pancreatic cancer. PACAP initiated a nationwide outcome registration database and biobanking projects which provides unique opportunities for improving care for these patients, in addition to developing new diagnostic and treatment strategies. After three years, several straightforward points of improvement in care and guideline compliance for patients with pancreatic cancer in the Netherlands were identified. The PACAP-1 trial was then launched to implement these improvements in care centers nationally. The three key best practices were:

  1. Optimal patient information and use of chemotherapy.
  2. Pancreatic enzyme replacement therapy and referral to a dietician in case of digestive issues.
  3. Use of metal stents to alleviate compression of the bile duct.


The aim of the PACAP-1 trial was to enhance the implementation of - and adherence to - key best practices in pancreatic cancer care at the 17 Dutch pancreatic centers and their associated regional networks. The implementation process includes monitoring, return visits, and provider feedback in combination with education and reminders. The trial, funded by the Dutch Cancer Society, will also assess the outcome of the program by evaluating the levels of implementation and compliance, and monitoring patient outcomes. Primary outcomes are 1-year overall survival, and secondary outcomes include 3- and 5- overall survival and quality of life for pancreatic cancer patients.

Data was collected through the registries within PACAP: the Netherlands Cancer Registry (NCR, oncological and survival data), the Dutch Pancreatic Cancer Audit (DPCA, surgical data), and the Patient Reported Outcome Measures recorded at set timepoints (PROMs, quality of life data).

The PACAP-1 trial started on May 22, 2018 and ended on July 9, 2020 with a total of 4,769 patients included. Results have not yet been published.

Read more about this paper on Biomed Central.

Researchers involved

PhD-students PACAP-1: Tara Mackay
Principal Investigators PACAP-1: Casper van Eijck