Recently, some students have been reading articles about the treatment drugs for progressive pancreatic cancer at the ASCO annual meeting in recent years, and now I am posting the students’ reading notes for the reference of patients and their families. Earlier, 5-Fu as the standard chemotherapy drug for progressive pancreatic cancer had a single-agent efficiency of less than 19%, with a median patient survival of 4.2-5.5 months. after 1997, gemcitabine came into clinical use, laying the cornerstone of modern chemotherapy for progressive pancreatic cancer. In the last decade, many studies have compared gemcitabine monotherapy with gemcitabine in combination with other chemotherapeutic agents for pancreatic cancer, such as fluorouracil, capecitabine, cisplatin, docetaxel, irinotecan, oxaliplatin, and pemetrexed, but none of them were effective in prolonging the survival of pancreatic cancer patients. In molecular biologic targeted therapy research, many targeted therapeutic agents are used in the clinic, and studies have proven that only drugs targeting the human epidermal growth factor receptor are effective in pancreatic cancer. Erlotinib in combination with gemcitabine (gemcitabine 1000 mg/m2 with 1 week off after 7 weeks and 1 week off every 3 weeks thereafter; erlotinib 100 mg/day) has been shown to be more effective than gemcitabine monotherapy (median survival 6.2 months vs. 5.9 months and 1-year survival 23 vs. 17%) and was once designated as a first-line treatment option for progressive pancreatic cancer by the US FDA. However, the clinical relevance of improving survival by only two weeks is still being explored. Additional studies of gemcitabine in combination with cetuximab or bevacizumab, or in combination with erlotinib for pancreatic cancer, have shown that these regimens do not differ significantly. Gemcitabine monotherapy is the basis of chemotherapy for progressive pancreatic cancer, and the FOLFIRINOX regimen is more effective than gemcitabine alone if tolerated by the patient, but the combination of three drugs with increased drug toxicity limits the clinical implementation of this regimen. The cost of capecitabine in combination with erlotinib also limits its use, and the 2011 ASCO annual meeting combined the results of several Japanese studies to suggest that S-1 is no less effective than gemcitabine and that S-1 in combination with gemcitabine is more effective in the treatment of advanced pancreatic cancer. For patients with pancreatic cancer who have failed first-line treatment, a recent study in Japan reported that resectable pancreatic cancer treated with S-1 after failure of gemcitabine monotherapy was highly effective, with a median survival of 11.7 months after recurrence and an overall median survival of 20.9 months.