Abstract

A 68-year-old male was admitted due to fatigue and poor appetite and diagnosed pathologically as pancreatic adenocarcinoma with liver metastasis. The patient received two cycles of modified FOLFIRINOX plus immune checkpoint inhibitor (Penpulimab). However, the tumor did not shrink and the tumor marker CA199 level was even higher; then anlotinib was added to therapeutic regimen. After another 4 cycles of combined treatment the size of primary tumor and metastatic lesions were significantly reduced. Laparoscopic distal panceatectomy and splenectomy as well as liver metastasis resection was performed. Three cycles of combined therapy were adopted after surgery followed by maintained therapy with anlotinib plus Penpulimab. There was no evidence of tumor recurrence 19 months since diagnosis.

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