Clinical characteristics of programmed death-1 inhibitors for older patients with advanced pancreatic cancer

Pancreatic cancer (PC), a highly malignant gastrointestinal cancer, is generally diagnosed at an advanced stage. However, traditional therapies for advanced PC are limited and often unsuitable for older patients.

To identify clinical predictors in older patients with advanced PC to facilitate individualized treatment.

This was a retrospective clinical analysis involving 99 patients aged ≥ 65 years with advanced PC who received programmed death-1 (PD-1) inhibitors at Ningbo Medical Center Lihuili Hospital from January 2019 to January 2025. Univariate and multivariate analyses were conducted to identify clinical predictors for survival outcomes, utilizing blood levels and other clinical information.

The median progression-free survival (PFS) was 4.6 months [95% confidence interval (CI): 3.700-5.800], and the median overall survival (OS) was 6.5 months (95%CI: 5.700-8.200). Multivariate analysis helped identify meaningful clinical differences in PFS and OS across subgroups, including factors such as Eastern Cooperative Oncology Group performance status, prognostic nutritional index, and triglyceride levels. Univariate analysis showed that factors such as the location of primary PC, carbohydrate antigen 199 levels, systemic immune-inflammation, neutrophil-to-lymphocyte ratio, and the combination therapy comprising PD-1 inhibitors and radiotherapy are of significant clinical relevance to both PFS and OS.

The treatment of advanced PC with PD-1 inhibitors presented several potential independent clinical predictive indicators of survival outcomes in older patients. This study highlighted the importance of pre-treatment clinical characteristics and hematological variables for predicting treatment outcomes in older patients with PC.