Simple SummaryPancreatic cancer remains a major therapeutic challenge despite medical advances. The incidence of pancreatic cancer is increasing, and this disease is associated with a high mortality and morbidity rate. The poor prognosis of pancreatic cancer can be attributed to several factors, including the difficulty of early diagnosis due to the lack of specific symptoms and biomarkers in the early stages, the aggressiveness of the disease, and its resistance to systemic therapies. However, recent advances in the field have led to promising new therapeutic strategies, and endoscopists have assumed a key role in the multidisciplinary management of this disease. The aim of this article is to provide a comprehensive literature review focused on examining existing treatments for various stages of pancreatic cancer, with an emphasis on new and innovative therapeutic approaches.AbstractPancreatic cancer remains a social and medical burden despite the tremendous advances that medicine has made in the last two decades. The incidence of pancreatic cancer is increasing, and it continues to be associated with high mortality and morbidity rates. The difficulty of early diagnosis (the lack of specific symptoms and biomarkers at early stages), the aggressiveness of the disease, and its resistance to systemic therapies are the main factors for the poor prognosis of pancreatic cancer. The only curative treatment for pancreatic cancer is surgery, but the vast majority of patients with pancreatic cancer have advanced disease at the time of diagnosis. Pancreatic surgery is among the most challenging surgical procedures, but recent improvements in surgical techniques, careful patient selection, and the availability of minimally invasive techniques (e.g., robotic surgery) have dramatically reduced the morbidity and mortality associated with pancreatic surgery. Patients who are not candidates for surgery may benefit from locoregional and systemic therapy. In some cases (e.g., patients for whom marginal resection is feasible), systemic therapy may be considered a bridge to surgery to allow downstaging of the cancer; in other cases (e.g., metastatic disease), systemic therapy is considered the standard approach with the goal of prolonging patient survival. The complexity of patients with pancreatic cancer requires a personalized and multidisciplinary approach to choose the best treatment for each clinical situation. The aim of this article is to provide a literature review of the available treatments for the different stages of pancreatic cancer.