Advanced pancreatic ductal adenocarcinoma with liver metastases treated with multimodal therapy: a case report

To investigate the therapeutic efficacy and survival benefits of a multidisciplinary team (MDT) strategy, including local interventional therapy, systemic chemotherapy, and immunotherapy, for patients with advanced pancreatic ductal adenocarcinoma (PDAC) presenting with liver metastasis at initial diagnosis.

A 54-year-old male patient was diagnosed with PDAC in the tail of the pancreas with multiple intrahepatic metastases (cT3N1M1, stage IV). The patient underwent multimodal comprehensive treatment, including iodine-125 seed implantation at the pancreatic primary site, eight cycles of hepatic arterial infusion chemotherapy, PD-L1 inhibitor (Benmelstobart), and oral S-1 maintenance therapy. After treatment, the patient's liver metastases significantly decreased in size (partial response according to RECIST 1.1), CA19-9 levels dropped from 4141.57 U/mL to 58.64 U/mL, overall survival exceeded 15 months, and quality of life remained good (ECOG score 1).

The MDT strategy, particularly the combination of local interventional therapy with systemic treatment and immunotherapy, can effectively control both the primary and metastatic lesions of advanced PDAC, significantly prolonging patient survival and providing valuable treatment references for similar cases.