Clinical characteristics of programmed death-1 inhibitors for older patients with advanced pancreatic cancer

doi:10.4251/wjgo.v18.i2.115562

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Feb 15, 2026 (publication date) through Feb 3, 2026

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Oncol. Feb 15, 2026; 18(2): 115562
Published online Feb 15, 2026. doi: 10.4251/wjgo.v18.i2.115562

Clinical characteristics of programmed death-1 inhibitors for older patients with advanced pancreatic cancer

Yun-Yun Lu, Pan Chen, Yi Lu

Yun-Yun Lu, Yi Lu, Department of Radiation Oncology, Ningbo Medical Center Lihuili Hospital, Ningbo 315048, Zhejiang Province, China

Pan Chen, Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo 315211, Zhejiang Province, China

Author contributions: Lu YY contributed to study concept and design, acquisition of data, analysis, and interpretation of data and drafting of the manuscript; Chen P and Lu P contributed to study concept and design, analysis and interpretation of data, and study supervision.

Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Ningbo Medical Center Lihuili Hospital.

Informed consent statement: The retrospective design of the study led to a waiver of informed consent.

Conflict-of-interest statement: All remaining authors have declared no conflicts of interest.

Data sharing statement: No additional data are available.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Yun-Yun Lu, Professor, Department of Radiation Oncology, Ningbo Medical Center Lihuili Hospital, No. 1111 Jiangnan Road, Ningbo 315048, Zhejiang Province, China. lhlluyunyun@nbu.edu.cn

Received: October 24, 2025
Revised: November 13, 2025
Accepted: December 11, 2025
Published online: February 15, 2026
Processing time: 106 Days and 4.2 Hours

Abstract

BACKGROUND

Pancreatic cancer (PC), a highly malignant gastrointestinal cancer, is generally diagnosed at an advanced stage. However, traditional therapies for advanced PC are limited and often unsuitable for older patients.

AIM

To identify clinical predictors in older patients with advanced PC to facilitate individualized treatment.

METHODS

This was a retrospective clinical analysis involving 99 patients aged ≥ 65 years with advanced PC who received programmed death-1 (PD-1) inhibitors at Ningbo Medical Center Lihuili Hospital from January 2019 to January 2025. Univariate and multivariate analyses were conducted to identify clinical predictors for survival outcomes, utilizing blood levels and other clinical information.

RESULTS

The median progression-free survival (PFS) was 4.6 months [95% confidence interval (CI): 3.700-5.800], and the median overall survival (OS) was 6.5 months (95%CI: 5.700-8.200). Multivariate analysis helped identify meaningful clinical differences in PFS and OS across subgroups, including factors such as Eastern Cooperative Oncology Group performance status, prognostic nutritional index, and triglyceride levels. Univariate analysis showed that factors such as the location of primary PC, carbohydrate antigen 199 levels, systemic immune-inflammation, neutrophil-to-lymphocyte ratio, and the combination therapy comprising PD-1 inhibitors and radiotherapy are of significant clinical relevance to both PFS and OS.

CONCLUSION

The treatment of advanced PC with PD-1 inhibitors presented several potential independent clinical predictive indicators of survival outcomes in older patients. This study highlighted the importance of pre-treatment clinical characteristics and hematological variables for predicting treatment outcomes in older patients with PC.

Keywords: Advanced pancreatic cancer; Older adults; Programmed death-1 inhibitors; Eastern Cooperative Oncology Group performance status; Prognostic nutritional index; Triglyceride

Core Tip: This study identified prognostic factors for older patients with advanced pancreatic cancer treated with programmed death-1 (PD-1) inhibitors. The findings indicated that PD-1 inhibitor therapy was safe in this older population. Key predictors of treatment prognosis included the Eastern Cooperative Oncology Group performance status, prognostic nutritional index, and triglyceride levels.