Case report: A successful case of targeted immunotherapy for locally advanced pancreatic cancer under non-surgical conditions.

Introduction: Locally advanced pancreatic cancer (LAPC) is a borderline unresectable malignancy that presents significant treatment challenges. The management of LAPC remains a complex issue, particularly in patients who are not eligible for surgical resection. Case: Here, we report the case of a 60-year-old woman diagnosed with LAPC through pathological biopsy who subsequently underwent targeted immunotherapy following the failure of a gemcitabine, oxaliplatin, and S-1 (G&S) chemotherapy regimen. Intervention: Based on next-generation sequencing (NGS), the patient's treatment regimen was adjusted to include albumin-bound paclitaxel and capecitabine chemotherapy, along with the PD-1 inhibitor camrelizumab (200 mg/cycle) for six cycles. Throughout the treatment period, the patient consistently declined surgical intervention. Imaging studies, including an upper abdominal computed tomography (CT), revealed the formation of a calcified layer surrounding the cancerous tissue in the pancreatic head. Remarkably, the patient has shown stable disease and no evidence of metastasis since the initiation of targeted immunotherapy. Conclusion: This case highlights the potential of targeted immunotherapy for the treatment of LAPC, particularly in non-surgical patients. A personalized approach guided by NGS, combined with immunotherapy, is an effective alternative to traditional treatment strategies for managing this challenging malignancy.