Abstract: Objective To investigate the relationship between C-reactive protein（CRP） kinetics and efficacy of the first-line chemotherapy and prognosis， as to analyze whether CRP can be one of the biological markers indicating the clinical prognosis of advanced pancreatic cancer. Methods Sixty-one patients with advanced pancreatic cancer in dignosis and treatment center of pancreatic cancer affiliated to Shanghai Jiaotong university from December 2008 to December 2013 were enrolled in this study. The 61 cases were assigned into four groups according to baseline CRP and CRP kinetics： group A1， patients whose baseline CRP≥5mg／L and never normalized（CRP＜5mg／L） during treatment； group A2， patients whose baseline CRP≥5mg／L and normalized at least one time during treatment； group B1， patients whose baseline CRP＜5mg／L and elevated（CRP≥5mg／L） at least one time during treatment and group B2， patients whose baseline CRP＜5mg／L and never elevated during treatment. The RECIST 1.1 criteria were used to evaluate the curative effect of overall and different CRP group. The Survival data were followed up and analyzed among different groups. The COX proportional hazard regression model was employed to analyze the independent prognostic factors of first-line chemotherapy for advanced pancreatic cancer. Results All patients were evaluable for efficacy. The disease control rate（DCR） was 50.82％ including PR 6 cases， SD 25 cases and PD 4 cases. Until December 31， 2013， 54 cases died and 7 cases survived with medium overall survival（OS） of 7.2 months and medium progressionfree survival（PFS） of 3.03 months. The DCR， medium OS and PFS of A1， A2， B1 and B2 groups were 35.0％， 54.6％， 41.2％ and 84.6％， 4.97， 8.87， 7.20 and 10.47 months， and 1.97， 3.83， 3.20， 6.90 months all with significant difference（P＜0.05）. The independent prognostic factors in patients with advanced pancreatic cancer includes baseline CRP， the dynamic changes of CRP， albumin and CA19-9 levels. Conclusion CRP is one of the biological markers indicating the clinical prognosis of advanced pancreatic cancer. Baseline CRP and CRP kinetics during first-line chemotherapy are independent factors for prognosis of advanced pancreatic cancer.