Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Oncol. Dec 15, 2026; 18(12): 125300
Published online Dec 15, 2026. doi: 10.4251/wjgo.125300
Published online Dec 15, 2026. doi: 10.4251/wjgo.125300
Durable disease control with multimodal treatment including fulzerasib, cetuximab and radiotherapy in locally advanced pancreatic cancer: A case report
Huan Luo, Zheng-Long Zhai, Jian Xu, Xiang Li, Yi-Wen Chen, Xue-Li Bai, Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Author contributions: Luo H and Chen YW had full access to all data in the study and take responsibility for the integrity and accuracy of the data analysis, they were involved in the acquisition, analysis, and interpretation of patient data, as well as the drafting of the manuscript; Zhai ZL, Xu J, and Li X contributed to the acquisition of clinical and pathological data, and critically revised the manuscript for important intellectual content; Chen YW and Bai XL developed the concept and design of this combination treatment, coordinated the overall treatment process, and supervised the data analysis; and all authors read, critically revised, and approved the final manuscript.
AI contribution statement: No AI tool was used to generate research data, interpret results, language polishing, or formulate conclusions.
Supported by Ling Yan Research and Development Program of Department of Zhejiang Province Science and Technology, No. 2026C02A1105 and No. 2024C03167.
Informed consent statement: The patient has signed the informed consent form
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Yi-Wen Chen, MD, Associate Chief Physician, Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310000, Zhejiang Province, China. cherry0705@zju.edu.cn
Received: July 6, 2026
Revised: August 1, 2026
Accepted: September 15, 2026
Published online: December 15, 2026
Processing time: 127 Days and 1.3 Hours
Revised: August 1, 2026
Accepted: September 15, 2026
Published online: December 15, 2026
Processing time: 127 Days and 1.3 Hours
Core Tip
Core Tip: This report presents the first known clinical application of a multimodal regimen combining the KRAS G12C inhibitor fulzerasib, the epidermal growth factor receptor antibody cetuximab, and localized carbon-ion radiotherapy in locally advanced pancreatic cancer harboring a KRAS G12C mutation. The treatment yielded durable disease control, extending progression-free survival beyond 19 months with a manageable safety profile in an 81-year-old patient unfit for conventional chemotherapy. This novel precision approach highlights the potential of combining dual-pathway targeted therapy with heavy-ion radiotherapy for KRAS-mutated locally advanced pancreatic cancer.