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Flow Cytometry-Based Isolation and Therapeutic Evaluation of Tumor-Infiltrating Lymphocytes in a Mouse Model of Pancreatic Cancer
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Advancing precision immunotherapy in advanced pancreatic cancer: a systematic review and meta-analysis of first-line

Xiaoqi Qi1, Haoran Yang2, Li Zhang3

  • 1School of Pharmacy, Tianjin Medical University, Tianjin, China.

Frontiers in Immunology
|July 25, 2026
PubMed
Abstract

Insights

First-line immune checkpoint inhibitor (ICI) combinations show promise in advanced pancreatic cancer, improving objective response rates but not definitively establishing survival benefits. Further large-scale trials are needed to confirm efficacy and safety in pancreatic ductal adenocarcinoma (PDAC).

Area of Science:

  • Oncology
  • Immunotherapy
  • Gastrointestinal Oncology

Background:

  • Pancreatic ductal adenocarcinoma (PDAC) has a very poor prognosis.
  • Immune checkpoint inhibitor (ICI) monotherapy has limited efficacy in PDAC.
  • The clinical value of first-line ICI-based combination regimens is unclear.

Purpose of the Study:

  • To evaluate the efficacy and safety of first-line ICI-based combination regimens in advanced PDAC.
  • To conduct a systematic review and meta-analysis of clinical studies.

Main Methods:

  • Systematic search of multiple databases (PubMed, Embase, Cochrane Library, etc.) up to April 2026.
  • Inclusion of eight clinical trials with 379 patients.
  • Data extraction and analysis following PRISMA guidelines.

Main Results:

  • ICI-based combinations showed favorable trends in overall survival (OS) and progression-free survival (PFS) in RCT-only analyses, though not statistically definitive.
  • Objective response rate (ORR) was significantly improved (OR = 2.19).
  • Single-arm analysis indicated a median PFS of 6.2 months and an ORR of 38.0%.
  • Increased risk of Grade 3+ adverse events was observed but manageable.

Conclusions:

  • First-line ICI-based combination regimens demonstrate encouraging antitumor activity in advanced PDAC, especially in radiological response.
  • Definitive survival benefits require confirmation through larger randomized trials.
  • Further research is warranted to optimize treatment strategies for advanced PDAC.
Keywords:
chemotherapycombination therapyefficacyfirst-line treatmentimmune checkpoint inhibitorsmeta-analysispancreatic ductal adenocarcinomasafety

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