title: Extended Survival after Complete Pathological Response in Metastatic Pancreatic Ductal Adenocarcinoma Following Induction Chemotherapy, Chemoradiotherapy, and a Novel Immunotherapy Agent, IMM-101.
abstract: Pancreatic ductal adenocarcinoma (PDAC) has an extremely poor prognosis. Median survival for metastatic patients is six to nine months and survivors beyond one year are exceptional. Pancreatic cancer is resistant to conventional chemotherapy and is often diagnosed at advanced stages. However, immunotherapy is a rapidly advancing new treatment modality, which shows promise in many solid tumor types.​ We present a patient with metastatic pancreatic cancer who underwent a synchronous resection of the primary tumour (pancreatoduodenectomy) and metastatic site (left hepatectomy) after multimodality neoadjuvant treatment with gemcitabine, nab-paclitaxel, and immunotherapy backbone with IMM-101 (an intradermally applied immunomodulator), as well as consolidation chemoradiation. Pathology of the specimens showed a complete response in both sites of the disease. The patient remains alive four years from the initial diagnosis and continues on maintenance immunotherapy. This exceptional response to initial chemo-immunotherapy was followed by a novel and off-protocol approach of low-dose capecitabine and IMM-101 as a maintenance strategy. The survival benefit and sustained performance status could set this as a new paradigm for the treatment of oligometastatic pancreatic cancer following response to systemic therapy and immunotherapy.​.
authors: Department of HPB Surgery, The Royal Marsden NHS Foundation Trust.
authors: Mafalda
authors: M
authors: Costa Neves
authors: Department of HPB Surgery, The Royal Marsden NHS Foundation Trust.
authors: Alex
authors: A
authors: Giakoustidis
authors: Section of Investigative Medicine, Division of Diabetes, Endocrinology & Metabolism, Faculty of Medicine, Imperial College.
authors: Gordon
authors: G
authors: Stamp
authors: London Oncology Clinic, Guy's and St. Thomas' NHS Foundation Trust.
authors: Andy
authors: A
authors: Gaya
authors: Department of Academic Surgery, The Royal Marsden NHS Foundation Trust ; Department of Surgery and Cancer, Imperial College London.
authors: Satvinder
authors: S
authors: Mudan
keywords: chemotherapy; imm-101; immunotherapy; neoadjuvant chemoradiation; pancreatic adenocarcinoma