Complete response to BRICS in Locally advanced pancreatic cancer (pMMR, CPS 30): a case report

This report suggests that a combined modality approach-integrating SBRT, chemotherapy, antiangiogenic therapy, ICI, and probiotics-may achieve CR in patients presenting with pMMR LAPC and high PD-L1 expression, even without surgery. These results challenge the prevailing assumption that pMMR status invariably predicts resistance to immunotherapy. These findings suggest that, in pMMR pancreatic cancers with high PD-L1 CPS, multimodal treatment strategies may remodel the tumor microenvironment and overcome immune resistance, highlighting a promising therapeutic direction.