The survey shows that there are 230,000 new cases of pancreatic cancer each year worldwide. On the whole, North America, Europe and Australia have the highest incidence rate, followed by Asia and Africa the lowest, and the incidence rate in countries or regions with high incidence of pancreatic cancer is 5 to 7 times higher than that in countries or regions with low incidence. In recent years, with the rapid economic development in China, the incidence of pancreatic cancer has also increased rapidly, with the current incidence rate reaching 6/100,000 for men and 4/100,000 for women. The prognosis of pancreatic cancer is extremely poor, and despite decades of efforts, the treatment effect is still unsatisfactory. American research data reported that the 1-year survival rate of pancreatic cancer without treatment is 8%, the 5-year survival rate is 3%, and the median survival period is only 2~3 months. The tumor itself has high malignancy, rapid development and high recurrence rate; the early symptoms are not typical, and most of them are late when diagnosed clinically, and most of them lose the opportunity of surgical resection; the high incidence of complications of radical pancreatic cancer surgery and high mortality rate can lead to great differences in treatment results. At present, the treatment of pancreatic cancer is still mainly surgery, and the 5-year survival rate after surgical treatment is generally about 10%, and the statistics of China’s surgical data show that the 5-year survival rate is only 5%. 5-FU and gemcitabine are commonly used drugs, and new drugs such as paclitaxel, ciclopirox and platinum oxalate have been used in clinical studies for the treatment of pancreatic cancer this year. Some reports have shown that gemcitabine and its combination chemotherapy can significantly improve the clinical benefit response of patients and is a better choice for patients with intermediate to advanced pancreatic cancer. The efficacy of radiation therapy for pancreatic cancer is not yet greatly improved compared with chemotherapy. For patients with recurrence and metastasis, most studies to date have shown minimal impact on prolonging survival and limited therapeutic effect, and patients are advised to preferably participate in controlled clinical studies. Gemcitabine is the standard of care for patients with locally advanced or metastatic pancreatic cancer. In 1997, a phase III comparative trial of gemcitabine (trade name, GEMZAR®) versus 5-fluorouracil (5-FU) showed a statistically significant improvement in symptom control and survival benefit in the gemcitabine (GEM group) treatment group compared to the 5-FU group. The “clinical benefit” rate was 23.8% in the GEM group and 4.8% in the 5-FU group, and the median survival time was 5.7 months in the GEM group and 4.4 months in the 5-FU group. Based on these results, gemcitabine is widely used in the United States as well as in Europe for the treatment of advanced pancreatic cancer, but its tumor remission rate (RR) is low at 5-15% and median survival time (MST) is 5-7 months. Tegeo capsule (S-1) is a compound oral chemotherapeutic agent, which consists of three drugs, namely, tegafur, gemcitracil and otelacil potassium, in a specific ratio. The main drug is tegafur, which is converted into 5-FU in the body to kill tumor cells. Clinical trials on S-1 in Japan began in 1993. S-1 has been approved for the treatment of these cancers and is widely used as monotherapy or in combination with other cytotoxic drugs. S-1 has been approved for the treatment of these cancers and is widely used as monotherapy or in combination with other cytotoxic agents in chemotherapy. An early phase III trial of advanced pancreatic cancer with distant metastases showed a tumor remission rate of 21.1% (4 out of 19 patients responded), with a time to progression (TTP) of 77 days and an MST of 169 days. Another phase II trial showed a tumor remission rate (RR) of 37.5% (15 of 40 subjects responded) with a TTP of 113 days and an MST of 281 days. These data support the approval of S-1 for the treatment of pancreatic cancer made in Japan in August 2006. Accordingly, a randomized phase III trial of gemcitabine versus S-1 versus gemcitabine/S-1 for the treatment of locally advanced pancreatic cancer or metastatic pancreatic cancer (hereafter referred to as the GEST trial) was conducted in Japan and Taiwan, China. The trial began on July 2, 2007 and has enrolled 834 cases as of December 2009, with trial follow-up expected to end on June 30, 2012. Preliminary results have shown a better safety and efficacy in the S-1 group. Gemcitabine in combination with the anti-angiogenic drug bevacizumab and the anti-EGFR monoclonal antibody cetuximab did not show an improvement in survival. The combination of gemcitabine with the small molecule tyrosine kinase inhibitor erlotinib also showed a very limited improvement in survival. In conclusion, so far, currently, gemcitabine is the standard drug for the treatment of pancreatic cancer, but it is important to note that gemcitabine improves the quality of life of patients with a low objective efficiency. The search for new drugs with more efficacy remains the direction of future efforts in pancreatic cancer treatment.