胰臟腺癌是預後極差的惡性腫瘤，因腫瘤的位置容易包覆血管，能接受根除性手術的比例很低，可切除的局部腫瘤採取術前化療(neoadjuvant chemotherapy)可以增加手術邊緣乾淨的機率並提高整體存活率，也能協助臨床醫師評估適合手術的病人。胰臟腺癌的腫瘤特性使得化療的反應率也不佳，術後化療及緩和化療以gemcitabine或是5-Fluorouracil (5-FU) 類的藥物為基礎發展，雞尾酒式的多種化療藥物組合及新一代的化療藥物nab-paclitaxel在胰臟癌的治療在近年來取得重要的進步，能提升病人存活率及生活品質。標靶藥物目前在胰臟癌的應用有限，針對生殖系(germline) BRCA突變的胰臟癌病人，使用PARP抑制劑olaparib已證實有一定療效。本文回顧胰臟癌的臨床表徵及治療進展，並介紹最近的臨床試驗結果。

Pancreatic adenocarcinoma is a malignancy with very poor prognosis. Because the mesenteric vessels are frequently involved in this cancer and the majority of patients were diagnosed at late stage. Less than 20% of patients are suitable to receive radical tumor resection. Neoadjuvant therapy can be considered for resectable or borderline resectable disease to improve surgical outcomes. Pancreatic adenocarcinoma is characterized by poor chemotherapeutic response due to the nature of malignancy. Gemcitabine-based or fluorouracil-based regimens are established as effective treatment for advanced pancreatic cancer. Precision medicine is a promising treatment strategy recently. This article provides a review on pancreatic adenocarcinoma, including clinical manifestations and recent treatment development.