Surufatinib and camrelizumab plus nab-paclitaxel–gemcitabine as first-line treatment for metastatic pancreatic ductal adenocarcinoma: a retrospective cohort study
Abstract
BackgroundSurufatinib targets angiogenic and myeloid signaling pathways that may contribute to resistance to immune checkpoint blockade in pancreatic ductal adenocarcinoma (PDAC). We evaluated surufatinib and camrelizumab added to nab-paclitaxel–gemcitabine (AG) in routine first-line treatment.MethodsThis exploratory single-center retrospective cohort included 132 patients with metastatic PDAC and documented proficient mismatch repair or microsatellite stability who started first-line treatment during 2022–2025. Forty-four received surufatinib–camrelizumab plus AG and 88 received AG. Real-world progression-free survival (rwPFS) was the primary outcome. Overall survival (OS), tumor response, safety, and treatment delivery were also assessed. Survival associations were adjusted for clinically selected baseline factors.ResultsMedian rwPFS was 6.3 months with the combination and 4.1 months with AG (log-rank P = 0.021); the adjusted hazard ratio was 0.73 (95% confidence interval [CI], 0.47–1.12; P = 0.152). Median OS was 9.7 versus 8.4 months (adjusted hazard ratio, 0.89; 95% CI, 0.57–1.38). Unconfirmed objective response rates were 45.5% and 19.3%, respectively (P = 0.004). Confirmed response rates were 38.6% and 15.9% (P = 0.005). CA19-9 declined more in the combination group among patients with eligible paired measurements (P = 0.032). Grade ≥3 adverse events occurred in 47.7% versus 34.1%, and toxicity-related permanent discontinuation occurred in 18.2% versus 11.4%. Median relative dose intensity was 87.0% versus 87.9% for both chemotherapy agents, 79.1% for prescribed surufatinib, and 100.0% for camrelizumab. Median follow-up by reverse Kaplan–Meier estimation was not estimable in either group.ConclusionSurufatinib–camrelizumab plus AG was associated with higher unconfirmed and confirmed response rates, without significant adjusted rwPFS or OS differences. The findings support prospective evaluation with attention to dose optimization and toxicity management.
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BibTeX
@article{yuan2026surufatinib,
title = {{Surufatinib and camrelizumab plus nab-paclitaxel–gemcitabine as first-line treatment for metastatic pancreatic ductal adenocarcinoma: a retrospective cohort study}},
author = {Yudong Yuan and Dongdong Zhang and Yuying Li and Chongbiao Huang},
journal = {Frontiers in Pharmacology},
year = {2026},
month = nov,
doi = {10.3389/fphar.2026.2007309},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.2007309},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Surufatinib and camrelizumab plus nab-paclitaxel–gemcitabine as first-line treatment for metastatic pancreatic ductal adenocarcinoma: a retrospective cohort study
AU - Yudong Yuan
AU - Dongdong Zhang
AU - Yuying Li
AU - Chongbiao Huang
PY - 2026
DA - 2026/11/05
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.2007309
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.2007309
AB - BackgroundSurufatinib targets angiogenic and myeloid signaling pathways that may contribute to resistance to immune checkpoint blockade in pancreatic ductal adenocarcinoma (PDAC). We evaluated surufatinib and camrelizumab added to nab-paclitaxel–gemcitabine (AG) in routine first-line treatment.MethodsThis exploratory single-center retrospective cohort included 132 patients with metastatic PDAC and documented proficient mismatch repair or microsatellite stability who started first-line treatment during 2022–2025. Forty-four received surufatinib–camrelizumab plus AG and 88 received AG. Real-world progression-free survival (rwPFS) was the primary outcome. Overall survival (OS), tumor response, safety, and treatment delivery were also assessed. Survival associations were adjusted for clinically selected baseline factors.ResultsMedian rwPFS was 6.3 months with the combination and 4.1 months with AG (log-rank P = 0.021); the adjusted hazard ratio was 0.73 (95% confidence interval [CI], 0.47–1.12; P = 0.152). Median OS was 9.7 versus 8.4 months (adjusted hazard ratio, 0.89; 95% CI, 0.57–1.38). Unconfirmed objective response rates were 45.5% and 19.3%, respectively (P = 0.004). Confirmed response rates were 38.6% and 15.9% (P = 0.005). CA19-9 declined more in the combination group among patients with eligible paired measurements (P = 0.032). Grade ≥3 adverse events occurred in 47.7% versus 34.1%, and toxicity-related permanent discontinuation occurred in 18.2% versus 11.4%. Median relative dose intensity was 87.0% versus 87.9% for both chemotherapy agents, 79.1% for prescribed surufatinib, and 100.0% for camrelizumab. Median follow-up by reverse Kaplan–Meier estimation was not estimable in either group.ConclusionSurufatinib–camrelizumab plus AG was associated with higher unconfirmed and confirmed response rates, without significant adjusted rwPFS or OS differences. The findings support prospective evaluation with attention to dose optimization and toxicity management.
SN - 1663-9812
ER -