Exocrine pancreatic cancer, mainly pancreatic ductal adenocarcinoma (PDAC), has a very poor prognosis and is one of the deadliest cancers worldwide because of its aggressive nature. It is often diagnosed at advanced stages, and standard chemotherapy usually has limited effectiveness. While improvements in surgical methods and the use of systemic chemotherapy have led to better outcomes for some patients, overall survival rates remain low. Recently, major advances in molecular and genetic studies have significantly improved our understanding of the biological processes behind PDAC progression. This progress has also helped in developing targeted therapies aimed at oncogenic drivers and parts of the tumor microenvironment.

This paper will explore recent developments in targeted therapies for pancreatic cancer. It focuses on molecular targets such as KRAS and its signaling pathways, DNA damage repair mechanisms including BRCA1/2 mutations, and changes in cell cycle regulation and growth factor signaling. It will also examine results from relevant clinical trials. Furthermore, it will consider the importance of biomarker-driven patient selection and personalized treatment methods.