Pancreatic cancer remains the fourth leading cause of cancer-related deaths. It is almost uniformly fatal, with the incidence rate approaching the mortality rate. Although small, potentially resectable tumour lesions may be detected by imaging methods, vast majority of patients are diagnosed in the advanced symptomatic stage of the disease. An affordable early screening test is still not available. The prognosis and surgical treatment of mostly elderly patients are further aggravated by the burden of concomitant comorbidities and the probability of cancer recurrence after resection. Gemcitabine is golden standard for systemic treatment of pancreatic cancer and has a small but encouraging impact on survival. Biological therapy with bevacizumab, cetuximab or panitumumab, which are proven effective in the treatment of patients with other gastrointestinal neoplasms, has no effect on survival of patients with pancreatic cancer. The possible exception is erlotinib, which has a minor but significant impact on the survival, especially in patients who develop skin rash during therapy. Pancreatic cancer continues to remain a great therapeutic challenge.

Key words:
gemcitabin; biologic therapy; pancreatic cancer, diagnosis, etiology