Case report: a case of R0 resection in a patient with PD-L1-negative, microsatellite-stabilized advanced pancreatic cancer after down-stage treatment with a PD-1 inhibitor in combination with chemotherapy.
{"title":"Case report: a case of R0 resection in a patient with PD-L1-negative, microsatellite-stabilized advanced pancreatic cancer after down-stage treatment with a PD-1 inhibitor in combination with chemotherapy.","authors":"Junqiang Dang, Qingqiang Wang, Yanling Yang, Lin Shang, Zeping Kang, Yu Jiang, Yanshun Ren, Hongjun Xiang","doi":"10.1007/s00432-025-06147-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pancreatic ductal adenocarcinoma (PDAC) is a gastrointestinal tumor with high morbidity and mortality. Despite advances in diagnostic and therapeutic modalities, the outcome and prognosis of PDAC remain poor. Most patients have locally advanced disease (30%-35%) or distant metastases (50%-55%) at the time of diagnosis. The treatment of unresectable pancreatic ductal adenocarcinoma (UR-PDAC) remains an urgent problem. In this study, we report that a patient with UR-PDAC underwent significant tumor shrinkage after PD-1 inhibitor combination chemotherapy, and obtained R0 (pathologically negative margin) resection and long-term survival.</p><p><strong>Case presentation: </strong>A 51-year-old woman was diagnosed with pancreatic cancer (stage III). She underwent 3 cycles of preoperative neoadjuvant therapy (NAT) with programmed cell death protein 1 (PD-1) antibody in combination with chemotherapy and the tumor shrank from 4.0 × 3.3 cm to 0.9 cm without significant adverse effects. The patient underwent conversion surgery (CS) and achieved R0 resection, and no tumor cells remained as confirmed by pathology.</p><p><strong>Conclusion: </strong>PD-1 antibody combination chemotherapy regimens have significant efficacy and do not add additional side effects in UR-PDAC patients, heralding advances in UR-PDAC treatment. We may have a way to give UR-PDAC patients access to curative treatment and long-term survival. This case of UR-PDAC patient with PD-L1-negative and microsatellite stability (MSS) gives us a more comprehensive understanding of the treatment options of immune-combination chemotherapy.</p>","PeriodicalId":15118,"journal":{"name":"Journal of Cancer Research and Clinical Oncology","volume":"151 4","pages":"128"},"PeriodicalIF":2.7000,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958446/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cancer Research and Clinical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00432-025-06147-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Pancreatic ductal adenocarcinoma (PDAC) is a gastrointestinal tumor with high morbidity and mortality. Despite advances in diagnostic and therapeutic modalities, the outcome and prognosis of PDAC remain poor. Most patients have locally advanced disease (30%-35%) or distant metastases (50%-55%) at the time of diagnosis. The treatment of unresectable pancreatic ductal adenocarcinoma (UR-PDAC) remains an urgent problem. In this study, we report that a patient with UR-PDAC underwent significant tumor shrinkage after PD-1 inhibitor combination chemotherapy, and obtained R0 (pathologically negative margin) resection and long-term survival.
Case presentation: A 51-year-old woman was diagnosed with pancreatic cancer (stage III). She underwent 3 cycles of preoperative neoadjuvant therapy (NAT) with programmed cell death protein 1 (PD-1) antibody in combination with chemotherapy and the tumor shrank from 4.0 × 3.3 cm to 0.9 cm without significant adverse effects. The patient underwent conversion surgery (CS) and achieved R0 resection, and no tumor cells remained as confirmed by pathology.
Conclusion: PD-1 antibody combination chemotherapy regimens have significant efficacy and do not add additional side effects in UR-PDAC patients, heralding advances in UR-PDAC treatment. We may have a way to give UR-PDAC patients access to curative treatment and long-term survival. This case of UR-PDAC patient with PD-L1-negative and microsatellite stability (MSS) gives us a more comprehensive understanding of the treatment options of immune-combination chemotherapy.
期刊介绍:
The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses.
The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.