ArticleJournal for immunotherapy of cancer2018
Acquired resistance to immunotherapy in MMR-D pancreatic cancer.
Article in Journal for immunotherapy of cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Efficacy and Safety of Combination Therapy With Immune Checkpoint Inhibitors and Chemotherapy With Gemcitabine and Nab-Paclitaxel in Pancreatic Cancer: A Systematic Review.Cancer medicine · 2026Pooled it
- Randomized, Multicenter, Phase II Trial of Gemcitabine and Cisplatin With or Without Veliparib in Patients With Pancreas Adenocarcinoma and a GermlineJournal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020Trial
- Case report: immunotherapy response in pancreatic cancer after MSI-H emerged post-chemotherapy.Frontiers in oncology · 2026Article
- Tumor Microenvironment: Recent Advances in Immunotherapies of Pancreatic Cancer.Medicina (Kaunas, Lithuania) · 2025Review
- IL-15 Complex Enhances Agonistic Anti-CD40 + Anti-PDL1 by Correcting the T-bet to Tox Ratio in CD8+ T cells Infiltrating Pancreatic Ductal Adenocarcinoma.Cancer immunology research · 2025Article
- Global Research Trends and Frontiers in Upper Tract Urothelial Carcinoma: A Comprehensive Visualization and Bibliometric Analysis.Journal of multidisciplinary healthcare · 2025Article
- The Trinity: Interplay among Cancer Cells, Fibroblasts, and Immune Cells in Pancreatic Cancer and Implication of CD8Biomedicines · 2022Review
- Distinct myeloid antigen-presenting cells dictate differential fates of tumor-specific CD8+ T cells in pancreatic cancer.JCI insight · 2022Article
- Insufficiency of compound immune checkpoint blockade to overcome engineered T cell exhaustion in pancreatic cancer.Journal for immunotherapy of cancer · 2022Article
- Clinical definition of acquired resistance to immunotherapy in patients with metastatic non-small-cell lung cancer.Annals of oncology : official journal of the European Society for Medical Oncology · 2021Article
- Pancreatic Cancer: A Review.JAMA · 2021Review
- Emerging principles of brain immunology and immune checkpoint blockade in brain metastases.Brain : a journal of neurology · 2021Review
- Forecasting sensitive targets of the kynurenine pathway in pancreatic adenocarcinoma using mathematical modeling.Cancer science · 2021Article
- CD40 Agonist Overcomes T Cell Exhaustion Induced by Chronic Myeloid Cell IL-27 Production in a Pancreatic Cancer Preclinical Model.Journal of immunology (Baltimore, Md. : 1950) · 2021Article
- An Update on Immune Checkpoint Therapy for the Treatment of Lynch Syndrome.Clinical and experimental gastroenterology · 2021Review
- Acquired Resistance to Immune Checkpoint Blockades: The Underlying Mechanisms and Potential Strategies.Frontiers in immunology · 2021Review
- Anti-PD1 therapy induces lymphocyte-derived exosomal miRNA-4315 release inhibiting Bim-mediated apoptosis of tumor cells.Cell death & disease · 2020Article
- T Cell Receptor Engineered Lymphocytes for Cancer Therapy.Current protocols in immunology · 2020Article
- Predictive biomarkers and mechanisms underlying resistance to PD1/PD-L1 blockade cancer immunotherapy.Molecular cancer · 2020Review
- Mechanisms Governing Immunotherapy Resistance in Pancreatic Ductal Adenocarcinoma.Frontiers in immunology · 2020Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundMMR-D pancreatic cancer have been reported to respond to checkpoint inhibitor therapy. Here, we report the first case of acquired resistance to immunotherapy in MMR-D pancreatic cancer. CASE PRESENTATION: A 45-year-old woman with unresectable MMR-D pancreatic cancer was initially treated with FOLFIRINOX, FOLFIRI, and stereotactic body radiation with stable disease burden. After 3 months, imaging showed progression of disease with an increase in CA19-9. She was subsequently enrolled in a clinical trial of an anti-PD-L1 antibody in combination with an IDO1 inhibitor. She demonstrated a partial response to therapy by RECIST 1.1 criteria with declining tumor markers. Twenty-two months after beginning immunotherapy, imaging revealed an increasing left ovarian cystic mass. There were no other sites of progressive disease. The patient underwent a total hysterectomy and bilateral salpingo-oophorectomy, appendectomy, omentectomy and pelvic lymphadenopathy. Pathology was consistent with a metastasis from the pancreas involving the endometrium and left ovary. Thereafter, the patient continued with PD-1 blockade therapy off protocol with no further progressive disease. Immune profiling showed high levels of CD8+ T cells and PD-1 positive immune cells infiltrating the tumor, with a moderate level of PD-L1 expression in both the immune cells and the tumor cells. Next generation sequencing found only the KRAS G12D and RNF43 G659Vfs*41 mutations were retained from the pre-treatment tumor in the treatment-resistant tumor.
conclusionsThis is the first report describing acquired resistance to immunotherapy in MMR-D pancreatic cancer with accompanying genomic and immune profiling. This case of oligoprogression in the setting of immunotherapy demonstrates the feasibility of localized treatment followed by continuation of immunotherapy to sustain ongoing response.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.