Front Immunol. 2025 Oct 2;16:1673098. doi: 10.3389/fimmu.2025.1673098. eCollection 2025.

ABSTRACT

INTRODUCTION: Pancreatic ductal adenocarcinoma (PDAC) continues to exhibit resistance to immunotherapy. In this study, we evaluated the efficacy of combining immunotherapy with chemotherapy for the treatment of advanced pancreatic cancer. Additionally, we employed a multimodal analytical approach to elucidate the immune landscape and conduct transcriptomic profiling in PDAC.

METHODS: A retrospective analysis was conducted on the clinical data of 52 patients diagnosed with advanced PDAC who underwent a combined treatment regimen of immunotherapy and chemotherapy. The study evaluated the objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS). To characterize the immune landscape in treatment-naive pancreatic ductal adenocarcinoma (PDAC) tumors and in the systemic circulation, flow cytometry, multiplex immunohistochemistry (mIHC), and whole transcriptome sequencing were employed.

RESULTS: The study reported an ORR of 32.7%, a DCR of 67.3%, and a 6-month PFS rate of 38.5%, with a median PFS of 5.5 months. Patients treated with a combination of immunotherapy and gemcitabine achieved the longest PFS. The first-line treatment cohort exhibited a significantly higher DCR (79.3% vs. 52.2%, P = 0.038) and a longer median PFS (6.6 vs. 3.5 months, P = 0.032) compared to the second-line treatment cohort. The efficacy of treatment varied depending on the drug combinations used. Flow cytometry analysis revealed a greater frequency of CD45- CD64+ cells in the peripheral blood of patients with progressive disease (PD) compared to those with a partial response (PR). Multiplex immunofluorescence (MIF) analysis indicated an increased intratumoral infiltration of CD8+ T cells and CD137+ CD8+ T cells in patients with PR. Whole transcriptome sequencing (WTSS) identified key genes involved in immune regulation, signal transduction, and digestive function. Hemopexin (HPX) and regulatory factor X-associated protein (RFXAP) were upregulated in PR patients and showed a positive correlation with survival, whereas Interleukin-6 (IL-6) expression was linked to poor prognosis.

CONCLUSIONS: These findings indicate that immunochemotherapy shows potential for the treatment of advanced PDAC. Our study elucidates the immune landscape associated with PDAC and provides critical insights for the identification of prospective therapeutic targets, which could guide the development of innovative combination immunotherapy strategies.

PMID:41112307 | PMC:PMC12528169 | DOI:10.3389/fimmu.2025.1673098

World J Clin Oncol. 2025 Jul 24;16(7):106981. doi: 10.5306/wjco.v16.i7.106981.

ABSTRACT

Cancer remains a major global health concern, with escalating incidence and mortality rates underscoring the urgent need for novel diagnostic and therapeutic strategies. Increasing evidence has identified the oral microbiota as a critical contributor to tumorigenesis, thereby expanding the understanding of cancer pathogenesis beyond conventional risk factors such as tobacco use and genetic predisposition. This review summarizes recent progress in elucidating the complex relationship between the oral microbiota and various malignancies, particularly oral squamous cell carcinoma, esophageal adenocarcinoma, and pancreatic ductal adenocarcinoma. Pathogenic bacteria, including Porphyromonas gingivalis and Fusobacterium nucleatum, have been implicated in promoting tumor progression through mechanisms involving chronic inflammation, the production of metabolic toxins, and immune evasion. The dysbiosis of the oral microbiota, often driven by lifestyle factors such as poor diet, tobacco use, and alcohol consumption, further exacerbates these carcinogenic processes. Emerging therapeutic approaches including probiotics, oral microbiota transplantation, and CRISPR-based bacterial editing are under investigation for their potential to restore microbial homeostasis and suppress pathogenic species. Additionally, saliva-based microbial biomarkers have shown promise for non-invasive cancer screening. The integration of multi-omics technologies and artificial intelligence-driven platforms is further advancing the development of precision oncology. This review aims to consolidate fragmented findings concerning the oral microbiota-cancer axis and address existing gaps in mechanistic understanding. The review's significance lies in the translational potential of microbial research to clinical applications, offering opportunities to reduce the global cancer burden through early detection and microbiota-targeted therapies.

PMID:40741186 | PMC:PMC12304933 | DOI:10.5306/wjco.v16.i7.106981