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A case report of advanced pancreatic neuroendocrine carcinoma with Ki67 80%, CPS 0, and pMMR achieving durable complete response for over 7 years after combination immunotherapy

Year: 2025
Type: article
Study design: Case Report
Abstract: Background: Pancreatic neuroendocrine carcinoma (pNEC) is a rare and aggressive malignancy. For patients with metastatic pNEC, the response to first-line chemotherapy remains unfavorable, with a median overall survival of less than one year. Furthermore, there are no standard-of-care therapeutic options following disease progression, representing a significant unmet clinical need. Case presentation: This is a case report of a patient diagnosed with metastatic pNEC presenting with upper abdominal pain, testing 80% positive for the Ki67 marker, a combined positive score (CPS) of 0, and proficient mismatch repair (pMMR). Following progression after chemotherapy, the patient received combination immunotherapy, involving multi-site, multi-dose, and multi-type radiotherapies combined with programmed death 1 (PD-1), accompanied by continuous probiotic supplementation. Imaging examination revealed that the tumor completely disappeared, and the patient maintained a no-evidence-of-disease (NED) status for over seven years. Conclusion: This case demonstrates that multi-site, multi-dose, and multi-type radiotherapies can more effectively reveal the heterogeneous tumor antigens, and the combined therapy of immunotherapy and probiotics may achieve sustained immune responses.
Language: English
Subfield: Epidemiology
Field: Medicine
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W4416841105
FWCI: 1.869
Cites: 33
Cited by: 3
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