Neoadjuvant Early Stereotactic Body Radiation Therapy Followed by Chemoimmunotherapy in Borderline Resectable and Locally Advanced Pancreatic Cancer
In brief
Early SBRT doubles progression-free survival to 12.5 months versus 6.6 months in borderline resectable pancreatic cancer
In a prospective trial of 22 patients, adding a short course of stereotactic body radiation to nab-paclitaxel, gemcitabine and camrelizumab lengthened median progression-free survival from 6.6 to 12.5 months, while overall survival trends favored the SBRT group. Surgery was achieved in 27% of patients with all margins negative, and severe toxicity was comparable between groups, suggesting the regimen is tolerable but needs larger validation.
- Journal
- Advances in radiation oncology (Q1)
- Published
- 1 July 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 4, Very Low (CEBM 4)
- Authors
- Shuhan Zhao, Jing Tang, Xin Li, Tao Yin, ShanMiao Gou, Jing Wang, et al.
- PMID
- 42571456
- DOI
- 10.1016/j.adro.2026.102128
Why clinicians should know about it
- Picked for Surgical Oncology (paper of the day, 10 August 2026).
- Picked for Surgery (paper of the day, 10 August 2026): Neoadjuvant SBRT plus chemoimmunotherapy for pancreatic cancer
Abstract
PURPOSE: Optimal neoadjuvant therapy for borderline resectable pancreatic cancer/locally advanced pancreatic cancer (BRPC/LAPC) remains undefined. This study evaluated the efficacy and safety of neoadjuvant nab-paclitaxel and gemcitabine plus camrelizumab, with or without early stereotactic body radiation therapy (SBRT), among patients with BRPC/LAPC. METHODS AND MATERIALS: This single-center, prospective trial enrolled adults with previously untreated BRPC/LAPC. Patients were assigned to an SBRT cohort, receiving early SBRT (25 Gy in 5 fractions) followed by nab-paclitaxel (125 mg/m2) plus gemcitabine (1000 mg/m2) on days 1 and 8 with camrelizumab (200 mg every 3 weeks), or to a non-SBRT cohort treated with the same chemoimmunotherapy alone. A multidisciplinary team determined whether patients underwent surgery or continued first-line therapy. The objective response rate served as the primary endpoint. RESULTS: A total of 22 patients were enrolled (11 in each cohort). The objective response rate was 36.4% (8/22), and disease-control rate was 100% (22/22). Six patients (27.3%) underwent surgery, and all achieved clinical-to-pathologic downstaging and R0 margins (6/6). With a median follow-up of 30.0 months (95% CI, 23.3-36.7), median progression-free survival was 12.5 months (95% CI, 9.6 to not available) in the SBRT cohort and 6.6 months (95% CI, 6.4 to not available) in the non-SBRT cohort in an exploratory between-cohort analysis (P = .003). Median overall survival was 20.8 and 13.9 months in the SBRT and non-SBRT cohorts, respectively (P = .261). Toxicity profiles were similar across cohorts, with grade ≥3 treatment-related adverse events occurring in 36.4% of patients. CONCLUSIONS: Neoadjuvant nab-paclitaxel and gemcitabine plus camrelizumab, with or without early SBRT, showed encouraging efficacy and acceptable tolerability for BRPC/LAPC. The potential benefit of early SBRT warrants further investigation.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.