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Correspondence to Author: Taizo Hoshino¹, Kazutoshi Kaketani²,Takao Itoi³Yuichi Nagakawa⁴, Tetsu Fukunaga⁵, Hajime Orita⁵, Tadashi Okabe⁶. 

1. Premiere Clinic, Tokyo, Japan
2. Hanzoumon Ichou Clinic, Tokyo, Japan
3. Tokyo Medical University Department of Gastroenterology and Hepatology, Tokyo, Japan
4. Tokyo Medical University Gastrointestinal and Pediatric Surgery, Tokyo, Japan
5. Esophageal & Gastroenterological Surgery, Juntendo University, Tokyo, Japan
6. Okabe Clinic, Tokyo, Japan

DOI: 10.52338/taoim.2025.4861

Abstract:

A 63 years-old female patient was found elevated CA19-9 levels during treatment for diabetes mellitus and further examinations led to a diagnosis of pancreatic body and tail cancer with multiple liver metastases. We performed whole-exome sequencing using a biopsy specimen and identified 70 somatic mutations, a part of which indicated generation of possible neoantigens in cancer cells. We then selected seven neoantigens that were predicted to have the high affinity to HLA molecules and administered 18 doses of neoantigen peptide-pulsed dendritic cell vaccine therapy as precision immunotherapy in addition to chemotherapies. CT images taken 3 years and 3 months later revealed the disappearance of both the primary tumor in the pancreas and all the liver metastases. Finally, we performed surgical resection of pancreatic tumor and confirmed the absence of cancer cells in the resected pancreas. Here, we report a case of advanced pancreatic cancer with multiple liver metastases where a combination therapy of precision immunochemotherapy and chemotherapy was effective, resulting in complete pathological remission confirmed in the surgically resected tissue.

Keywords: pancreatic cancer, genome analysis, precision, neoantigen, chemotherapy, multiple liver metastases, complete cure.

Citation:

Taizo Hoshino, Pancreatic Body And Tail Cancer With Multiple Liver Metastases Cured By Precision Immunochemotherapy: A Case Report. The Annals of Internal Medicine 2025.