Zhang JW. Letter to the editor: Role of adjuvant programmed death-1 blockade combined with chemotherapy in resected pancreatic ductal adenocarcinoma. World J Gastrointest Oncol 2026; 18(9): 119518 [DOI: 10.4251/wjgo.119518]
Corresponding Author of This Article
Jin-Wei Zhang, PhD, Principal Investigator, Professor, State Key Laboratory of Chemical Biology, Research Center of Chemical Kinomics, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, No. 345 Lingling Road, Shanghai 200032, China. jinweizhang@sioc.ac.cn
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Oncology
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letter
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Zhang JW. Letter to the editor: Role of adjuvant programmed death-1 blockade combined with chemotherapy in resected pancreatic ductal adenocarcinoma. World J Gastrointest Oncol 2026; 18(9): 119518 [DOI: 10.4251/wjgo.119518]
World J Gastrointest Oncol. Sep 15, 2026; 18(9): 119518 Published online Sep 15, 2026. doi: 10.4251/wjgo.119518
Letter to the editor: Role of adjuvant programmed death-1 blockade combined with chemotherapy in resected pancreatic ductal adenocarcinoma
Jin-Wei Zhang
Jin-Wei Zhang, State Key Laboratory of Chemical Biology, Research Center of Chemical Kinomics, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 200032, China
Author contributions: Zhang JW designed the overall concept and outline of the manuscript, contributed to the discussion and design of the manuscript, the writing and editing of the manuscript, illustrations, and review of the literature; and the author thoroughly reviewed and endorsed the final manuscript.
AI contribution statement: AI tools (Grammarly and DeepL) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Supported by the National Natural Science Foundation of China, No. 82170406 and No. 81970238.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Corresponding author: Jin-Wei Zhang, PhD, Principal Investigator, Professor, State Key Laboratory of Chemical Biology, Research Center of Chemical Kinomics, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, No. 345 Lingling Road, Shanghai 200032, China. jinweizhang@sioc.ac.cn
Received: January 30, 2026 Revised: February 12, 2026 Accepted: May 7, 2026 Published online: September 15, 2026 Processing time: 208 Days and 6 Hours
Abstract
Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal solid malignancies, with high rates of early recurrence even after curative-intent surgery and optimal adjuvant chemotherapy. While immune checkpoint inhibitors targeting programmed death-1 have transformed outcomes in several cancers, their efficacy in advanced PDAC has been limited, largely due to a profoundly immunosuppressive tumor microenvironment. In this context, the real-world cohort study by Cao et al in the World Journal of Gastrointestinal Oncology explores the clinical value of combining programmed death-1 inhibition with adjuvant chemotherapy in patients with resected PDAC. The study reports a significant improvement in recurrence-free and distant metastasis-free survival without a concomitant increase in severe toxicity. This article critically appraises these findings in light of existing literature, discusses their biological plausibility, and outlines future directions for biomarker-driven, prospective evaluation of adjuvant immunotherapy in PDAC.
Core Tip: Although immune checkpoint inhibitors have shown minimal efficacy in advanced pancreatic cancer, the postoperative adjuvant setting may offer a biologically favorable window for immune intervention. A recent study suggested that combining programmed death-1 inhibition with chemotherapy after surgical resection may improve recurrence-related outcomes without excessive toxicity, providing a compelling rationale for prospective, biomarker-informed trials in this historically refractory disease.
