Near Complete Pathologic Response to PD-1 Inhibitor and Radiotherapy in a Patient with Locally Advanced Pancreatic Ductal Adenocarcinoma

Abstract

Patrick M McCarthy,1 Matthew J Rendo,2 Matthew D Uy,3 Alexandra M Adams,1 Anne E O’Shea,1 Daniel William Nelson,4 Joshua L Fenderson,2 Katherine M Cebe,3 Robert W Krell,1 Guy T Clifton,1 George E Peoples,5 Timothy J Vreeland1 1Department of Surgery, Brooke Army Medical Center, San Antonio, TX, USA; 2Department of Hematology and Oncology, Brooke Army Medical Center, San Antonio, TX, USA; 3Department of Pathology, Brooke Army Medical Center, San Antonio, TX, USA; 4Department of Surgery, William Beaumont Army Medical Center, El Paso, TX, USA; 5Cancer Vaccine Development Program, San Antonio, TX, USACorrespondence: Patrick M McCarthyDepartment of Surgery, Brooke Army Medical Center, 3551 Roger Brooke Dr., San Antonio, TX, 78234, USATel [phone]Fax [phone]Email [email protected]: Pancreatic ductal adenocarcinoma (PDAC) remains deadly despite advances in systemic therapies and surgical techniques. While there is increasing utilization of immune therapies across diverse cancer types, PDAC remains generally resistant to these treatments. We report a case of locally advanced PDAC treated with preoperative radiation and anti-PD-1 immunotherapy guided by preoperative PD-L1 tumor analysis. After 4 months of preoperative therapy, the patient was submitted to resection, demonstrating a near-complete pathologic response on final tumor analysis. We will discuss the relevant literature and current state of immunotherapeutics for PDAC.Keywords: pancreatic cancer, pembrolizumab, complete response, PD-L1, locally advanced, immune checkpoint inhibitor

Keywords

• pancreatic cancer
• pembrolizumab
• complete response
• pd-l1
• locally advanced
• immune checkpoint inhibitor