Efficacy and safety of neoadjuvant chemotherapy with AG regimen with or without nimotuzumab in borderline resectable or locally advanced pancreatic cancer: A retrospective cohort study.

e16375 Background: This study aimed to evaluate whether adding nimotuzumab to an albumin-bound paclitaxel plus gemcitabine (AG) regimen could improve outcomes in these patients. Methods: We analyzed data from 100 patients with BRPC/LAPC. Patients were divided into a control group (AG alone, n=57) and a study group (AG+nimotuzumab, n=43). The primary endpoint was overall survival (OS). Results: The disease control rate was 100% in both groups. The objective response rate was higher in the study group (12% vs. 4%, P=0.238), accompanied by a significantly greater mean reduction in tumor diameter (-13.7% vs. -8.2%, P=0.019). The R0 resection rate was comparable (81.4% vs. 87.7%, P=0.552). As of May 5, 2025, the median OS (mOS) was not significantly different between groups (25 vs. 24 months, P=0.229). However, in the high EGFR expression subgroup (n=50), the study group showed significantly longer mOS (33 vs. 23 months, P=0.016). Similarly, in this subgroup, the study group had favorable trends in median PFS (23 vs. 16 months, P=0.051) and significantly longer median disease-free survival (25 vs. 16 months, P=0.0025). The median PFS in the overall population was 18 vs. 17 months (P=0.279). The safety profile was comparable, with grade 3 adverse events occurring in 7.0% (control) and 4.7% (study) of patients. Conclusions: The addition of nimotuzumab to neoadjuvant AG chemotherapy demonstrated promising efficacy, particularly in patients with high EGFR expression, and was well-tolerated. These results support further investigation in prospective randomized trials.