Borz Paul-Cristian, Borz Mihnea Bogdan, Borz Oliviu-Cristian, Zaharie Toader, Hagiu Claudia, Munteanu Lidia, Gurzu Simona
George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu-Mures, 540142 Targu Mures, Romania.
Gastroenterology Department, Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor, 400394 Cluj-Napoca, Romania.
Medicina (Kaunas). 2025 Jun 11;61(6):1076. doi: 10.3390/medicina61061076.
: Despite advances in chemotherapy and supportive care, pancreatic ductal adenocarcinoma (PDAC) continues to carry a dismal prognosis, with a five-year survival rate of approximately 13%. While immunotherapy has revolutionized treatment for several malignancies, its efficacy in PDAC remains limited. Recent research has shifted focus toward integrating immunotherapy with chemotherapy, radiation, and targeted therapies in an effort to overcome therapeutic resistance and improve outcomes. Ongoing clinical trials are actively investigating these multimodal strategies. : A systematic search was conducted using PubMed and ScienceDirect to identify relevant studies published in the past six years. Search terms included "pancreatic adenocarcinoma immunotherapy," "pancreatic cancer treatments," and "combination treatments for pancreatic adenocarcinoma." Only English-language articles were included. : A total of 126 articles were initially identified through the database search. After a full-text screening, 48 articles were deemed potentially relevant. Following a rigorous review, 11 studies met the inclusion criteria and were selected for analysis. These studies included randomized controlled trials, non-randomized controlled trials, and retrospective studies. Meta-analyses and case reports were excluded. Articles that failed to meet the inclusion criteria were excluded, primarily due to the absence of relevant data addressing the main objective of this review. : Combination strategies with immunotherapy and chemotherapy offer modest survival gains in metastatic settings, yet efforts in resectable and borderline resectable disease have fallen short. These outcomes reflect the profound immunosuppressive forces of the PDAC microenvironment. A new era of treatment must move beyond broad immunotherapeutic applications toward a precision-driven model. Molecular markers, such as KRAS mutations and circulating tumor DNA (ctDNA) profiles, are beginning to illuminate paths for personalized therapy selection. Future progress will depend on biomarker-guided clinical trials, a deeper understanding of immune resistance mechanisms, and bold innovation at the intersection of immunology and tumor biology.
尽管化疗和支持治疗取得了进展，但胰腺导管腺癌（PDAC）的预后仍然很差，五年生存率约为13%。虽然免疫疗法已经彻底改变了几种恶性肿瘤的治疗方式，但其在PDAC中的疗效仍然有限。最近的研究已将重点转向将免疫疗法与化疗、放疗和靶向疗法相结合，以克服治疗耐药性并改善治疗效果。正在进行的临床试验正在积极研究这些多模式策略。
使用PubMed和ScienceDirect进行了系统检索，以识别过去六年发表的相关研究。检索词包括“胰腺腺癌免疫疗法”、“胰腺癌治疗”和“胰腺腺癌联合治疗”。仅纳入英文文章。
通过数据库检索最初共识别出126篇文章。经过全文筛选，48篇文章被认为可能相关。经过严格审查，11项研究符合纳入标准并被选入分析。这些研究包括随机对照试验、非随机对照试验和回顾性研究。排除荟萃分析和病例报告。未符合纳入标准的文章被排除，主要是因为缺乏解决本综述主要目标的相关数据。
免疫疗法与化疗的联合策略在转移性情况下能带来适度的生存获益，但在可切除和临界可切除疾病方面的努力尚未取得成效。这些结果反映了PDAC微环境中强大的免疫抑制力量。治疗的新时代必须超越广泛的免疫治疗应用，转向精准驱动的模式。分子标志物，如KRAS突变和循环肿瘤DNA（ctDNA）谱，正开始为个性化治疗选择指明方向。未来的进展将取决于生物标志物引导的临床试验、对免疫抵抗机制的更深入理解以及免疫学和肿瘤生物学交叉领域的大胆创新。
