tislelizumab combined with nab-paclitaxel and gemcitabine for recurrent pancreatic cancer

Conditions: Recurrent Pancreatic Cancer

Summary: to evaluate the efficacy of tislelizumab combined with nab-paclitaxel and gemcitabine in the treatment of recurrent pancreatic cancer

there is heterogeneity in desmoplasia between different metastatic sites in pancreatic cancer. the tumor quasi-characteristics of patients with metastatic pdac at presentation were more obvious than those of epithelial characteristics, and the quasi-and epithelial subtypes showed different responses to chemotherapy regimens, and the epithelial phenotype tumor quasi-phenotype was associated with metastasis-free survival. therefore, different metastases of pancreatic cancer may respond differently to medical treatment. there were different metastases after postoperative recurrence of pancreatic cancer, 25.2% had only liver metastases, 14.7% had only lung metastases, 14.7% had multiple distant metastases, and about more than half of the patients had postoperative recurrence with only distant metastases and no in situ metastasis. then whether there is a difference in the efficacy of pd1 drug therapy in patients with different metastases needs to be further verified.

Eligibility criteria:
inclusion criteria: * patients with radiologically or histologically confirmed postoperative recurrent pancreatic cancer * patients with at least one measurable lesion (according to recist 1.1 criteria); * have not received gemcitabine-based regimen after surgery * no systemic treatment after diagnosis of recurrence * ecog score 0-1 * expected survival ≥ 3 months; * liver function is essentially normal: absolute neutrophil count \> 1500/mm ³; platelet count \> 100,000/mm ³; creatinine less than 1.5 times the upper limit of normal or calculated creatinine clearance (crci) \> 45 ml/min; total bilirubin ≤ 2.0 mg/dl; aspartate aminotransferase (ast) and alanine aminotransferase less than 2.5 times the upper limit of normal * appropriate to participate in this trial as assessed by the investigator before entering the study * male and female subjects of childbearing potential must agree to use an effective method of contraception throughout the study * signed informed consent form exclusion criteria: * patients who only undergo abdominal laparotomy but do not undergo resection of pancreatic tumor tissue * received gemcitabine-based regimen after surgery * systemic treatment after diagnosis of recurrence * patients with previous allergic reactions to similar drugs * pregnant or lactating patients * presence of pericardial effusion, uncontrolled pleural effusion, or clinically significant ascites at screening (including detectable ascites or ascites requiring puncture and aspiration on physical examination at screening) * history of interstitial lung disease, pneumonitis, or uncontrolled systemic disease, including diabetes, hypertension, pulmonary fibrosis, acute lung disease, etc * patients with severe cardiovascular diseases within 12 months before enrollment, such as symptomatic coronary heart disease, ≥ grade ii congestive heart failure, uncontrolled arrhythmia, myocardial infarction, etc * presence of any active immunodeficiency or autoimmune disease and/or history of any immunodeficiency or autoimmune disease that may recur at screening (e.g., hypothyroidism or hyperthyroidism, interstitial pneumonia, enteritis, hepatitis, hypophysitis, vasculitis, myocarditis, etc) * use of steroids or other systemic immunosuppressive therapy 14 days prior to enrollment * patients with other previous malignancies who are not cured * immunodeficient patients, such as hiv-positive * uncontrollable psychosis