Pancreatic cancer has a very high mortality rate and affects approximately 
230,000 individuals worldwide. Gemcitabine has become established as the 
standard therapy for advanced pancreatic cancer; however, the survival advantage 
is small. Adjuvant chemotherapy using either 5-fluorouracil or gemcitabine is 
now established in pancreatic cancer as an alternative therapy. Combinations of 
gemcitabine with either platin agents or capecitabine may be advantageous. 
Anti-EGFR and anti-VEGF agents have been unsuccessful but multiple tyrosine 
kinase inhibitors are under investigation. Of the increasing number of 
immunological agents, the GV1001 antitelomerase vaccine holds some interest. 
Targeted agents against important mitogenic pathways, including MEK/ERK, Src, 
PI3K/Akt, mTOR, Hedgehog and NF-kappaB, as well as agents targeting histone 
deacetylase, poly(ADP-ribose) polymerase, heat shock protein 90 and other agents 
such as beta-lapachone, hold considerable interest for further development. 
However, the probability of individual success is low.