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• W4387498197 abstract "Immunotherapy alone offered limited survival benefits in pancreatic cancer, while the role of immunotherapy-centric combined therapy remains controversial. Therefore, it is required to develop biomarkers to precisely deliver immunotherapy-based multimodality for pancreatic cancer.This is a secondary analysis of an open label, randomized, phase 2 trial, whereas patients with locally recurrent pancreatic cancer after surgery were enrolled. Eligible patients with mutant KRAS and positive immunohistochemical staining of PD-L1 were randomly assigned to receive stereotactic body radiation therapy (SBRT) plus pembrolizumab and trametinib (SBRT+K+M) or SBRT and gemcitabine (SBRT+G). Meanwhile, patients were classified into PD-L1+/tumor infiltrating lymphocytes [TIL(s)]- and PD-L1+/TIL+ group for each arm.A total of 170 patients were enrolled and randomly assigned to receive SBRT+K+M (n=85) or SBRT+G (n=85). The improved outcomes have been reported in patients with SBRT+K+M in the previous study. In this secondary analysis, the median overall survival (OS) was 17.2 months (95% CI 14.6-19.8 months) in patients with PD-L1+/TIL+ and 12.7 months (95% CI 10.8-14.6 months) in patients with PD-L1+/TIL- (HR 0.62, 95% CI 0.39-0.97, p=0.036) receiving SBRT+K+M. In SBRT+G group, the median OS was 13.1 months (95% CI 10.9-15.3 months) in patients with PD-L1+/TIL- and 12.7 months (95% CI 9.2-16.2 months) in patients with PD-L1+/TIL+ (HR 0.97, 95% CI 0.62-1.52, p=0.896). Grade 3 or 4 adverse events were found in 16 patients (30.8%) and 10 patients (30.3%) with PD-L1+/TIL- and PD-L1+/TIL+ in SBRT+K+M group respectively; whereas 9 (16.7%) and 8 patients (25.8%) with PD-L1+/TIL- and PD-L1+/TIL+ in SBRT+G group.PD-L1, TILs and mutant KRAS may be a biomarker to guide clinical practice of radiotherapy and immunotherapy-based regimens in pancreatic cancer if further combined with MEK inhibitors as targeted therapy." @default.
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• W4387498197 date "2023-10-01" @default.
• W4387498197 modified "2023-10-13" @default.
• W4387498197 title "Immune profiling of pancreatic cancer for radiotherapy with immunotherapy and targeted therapy: biomarker analysis of a randomized phase 2 trial" @default.
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• W4387498197 doi "https://doi.org/10.1016/j.radonc.2023.109941" @default.
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