CASE REPORT article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
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
Provisionally accepted
- The 900th Hospital of Joint Logistics Support Force, Fuzhou, China
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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.
Keywords: Immunotherapy, neuroendocrine carcinoma, Probiotics, radiation therapy, case report
Received: 08 Aug 2025; Accepted: 21 Nov 2025.
Copyright: © 2025 Fan, Xu, Wu, Li and Peng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yonghai Peng, 1208852065@qq.com
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