Pancreatic cancer is well known most lethal malignancy. Despite substantial improvements in the survival rates for other major cancer, the survival of pancreatic cancer has remained relatively unchanged. Since the introduction of potent chemotherapeutic agents such as FOLFIRINOX and Gem-Abraxane, dramatic increase of survival and resection rate could be seen. The role of multidisciplinary treatment is increasingly important. However the most of important studies have been released from Western countries in which pharmacodynamics is different. The response rate and toxicity must be different. So direct application is sometimes difficult in Asian peoples. In the past, the incidence of pancreatic cancer was relatively low in the most of Asian countries. With the improvement of economy and changing living habit including dietary pattern, the incidence of pancreatic cancer has increased in our region. Especially far eastern region has high incidence of pancreatic cancer similar to western country. So we need the optimal treatment based on our evidence suitable to our patients. Considering the high-level surgical skill in Asian surgeons and different pharmacodynamics of Asian patients, we must build our high-level evidence in the treatment of pancreatic cancer. However, there is no study consortium in our region. In this symposium I will talk about the current international study groups on pancreas and stress the need for strong collaboration between Asian country to make a global study network.