Pancreatic cancer ranks among the most lethal malignancies worldwide. Most patients are no longer candidates for surgery at diagnosis, making systemic therapy the cornerstone of management. Currently, chemotherapy remains the foundational regimen for systemic treatment, yet conventional regimens face limitations such as suboptimal response and significant toxicity. Recent years have witnessed groundbreaking advances in pancreatic cancer therapeutics, including innovations in chemotherapy formulations, development of classic target agents, discovery of novel targets, application of antibody-drug conjugates, exploration of immunotherapy, and breakthroughs in cancer vaccines and cellular therapies. These developments offer new perspectives for improving patient prognosis.