Synergistic immunotherapy in pancreatic cancer: a case study and in-depth review

The advent of immune checkpoint inhibitors has significantly advanced oncology, presenting new therapeutic avenues for a variety of cancers. Despite their success in managing melanoma, lung cancer, renal cell carcinoma, colorectal cancer, and hepatocellular carcinoma, their efficacy in pancreatic ductal adenocarcinoma (PDAC), particularly microsatellite stable (MSS) cases, is notably limited. This report delineates an extraordinary case of a patient with metastatic PDAC concomitant with autoimmune pancreatitis (AIP), which exhibited a partial response to an innovative treatment regimen comprising a PD-1 inhibitor, chemotherapy, and anlotinib. This regimen was well-tolerated, and next-generation sequencing analysis affirmed MSS status. The pronounced therapeutic response observed in this metastatic pancreatic cancer scenario is exceptionally uncommon. We reported an old female with metastatic MSS PDAC. The patient achieved a partial response and exhibited good tolerance to a treatment regimen that included a PD-1 inhibitor, chemotherapy, and anti-vascular agents and extended overall survival of over 25 months. Our findings suggest that certain patients with metastatic MSS PDAC, particularly those with AIP, may demonstrate enhanced sensitivity to and benefit from immunotherapy. These observations underscore the potential for personalized immunotherapy approaches in this patient subgroup, warranting further investigation.