Pancreatic cancer survival is poor for those with high-grade malignancy, so multidisciplinary therapy is required for pancreatic cancer patients. Borderline resectable pancreatic cancer patients, according to the National Comprehensive Cancer Net- work(NCCN), have a high incidence of R1/2 resection, which demonstrates poor survival. It is thought that not only postoperative therapy but also preoperative therapy is essential to improve the survival of advanced pancreatic cancer patients. Preoperative chemoradiotherapy leads to R0 resection, resulting in improved survival of borderline resectable pancreatic cancer patients. Metastatic disease survival might be improved by intensive chemotherapy, and super-responder chemotherapy might be performed for resection, which means the new concept of adjuvant chemotherapy. On the other hand, antigenspecific CD8-positive CTL is generated by stimulation of peptide. Three clinical trials are on-going using OCV-101, OCV-105, and OTS-102, respectively. The development of a peptide vaccine used as a medicine is anticipated.