Pancreatic cancer is characterized by its insidious onset, which is easy to be present with liver metastasis or other distant organ metastasis at advanced stage, so the prognosis is extremely poor with 5-year survival rate being 4%-6%. Radical resection may be the only curative treatment. How-ever, most patients have lost the chance for surgical resection because of late diagnosis, and the resection rate is less than 20%. What's more, postoperative complications and recurrence make influence on pa-tients' quality of life without significant improvement. For now gemcitabine acting as the gold standard chemotherapy for the treatment of pancreatic cancer, approved by FDA as the first-line chemotherapy drug, can significantly prolong patients' lifetime. Gemcitabine combined with other drugs not only increase the anti-tumor effect, but also decrease the frequency of adverse events and drug resistance. Combination therapy such as gemcitabine+nab-paclitaxel, gemcitabine+erlotinib, gemcitabine+capecitabine have be recommended as the first-line therapy for the treatment of pancreatic cancer by the latest NCCN Guide-lines. This article reviews the most current articles, looking for developments about the gemcitabine-based first-line therapies in order to find better treatment and research strategy of pancreatic cancer.