Publication Name	World Journal of Gastroenterology
Manuscript ID	90472
Country	China

Category	Oncology
Manuscript Type	Case Report
Article Title	PRaG 3.0 therapy for human epidermal growth factor receptor 2-positive metastatic pancreatic ductal adenocarcinoma: A case report
Manuscript Source	Unsolicited Manuscript
All Author List	Yue-Hong Kong, Mei-Ling Xu, Jun-Jun Zhang, Guang-Qiang Chen, Zhi-Hui Hong, Hong Zhang, Xiao-Xiao Dai, Yi-Fu Ma, Xiang-Rong Zhao, Chen-Yang Zhang, Rong-Zheng Chen, Peng-Fei Xing and Li-Yuan Zhang
Funding Agency and Grant Number	Funding Agency Grant Number Suzhou Medical Center Szlcyxzx202103 National Natural Science Foundation of China 82171828 Key R&D Plan of Jiangsu Province (Social Development) BE2021652 Subject Construction Support Project of The Second Affiliated Hospital of Soochow University XKTJHRC20210011 Wu Jieping Medical Foundation 320.6750.2021-01-12 Special Project of “Technological Innovation” Project of CNNC Medical Industry Co. Ltd ZHYLTD2021001 Suzhou Science and Education Health Project KJXW2021018 Foundation of Chinese Society of Clinical Oncology Y-pierrefabre202102-0113 Beijing Bethune Charitable Foundation STLKY0016 Research Projects of China Baoyuan Investment Co. 270004 Suzhou Gusu Health Talent Program GSWS2022028 Open Project of State Key Laboratory of Radiation Medicine and Protection of Soochow University GZN1202302
Corresponding Author	Li-Yuan Zhang, PhD, Chief Physician, Center for Cancer Diagnosis and Treatment, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou 215000, Jiangsu Province, China. zhangliyuan@suda.edu.cn
Key Words	Pancreatic ductal adenocarcinoma; PRaG 3.0 therapy; Human epidermal growth factor receptor 2; Novel combination therapy; Case report
Core Tip	Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer-related death worldwide. Herein, we present a case of multiple metastatic PDAC with immunohistochemistry (IHC) mismatch repair proficient but human epidermal growth factor receptor 2 (HER-2) IHC weakly positive at diagnosis that didn’t have tumor regression after first-line nab-paclitaxel plus gemcitabine and PD-1 inhibitor treatment. A novel combination therapy PRaG 3.0 of RC48 (HER2-antibody-drug conjugate), radiotherapy, PD-1 inhibitor, granulocyte-macrophage colony-stimulating factor and interleukin-2 was then applied as second-line therapy and the patient had confirmed good partial response with progress-free-survival of 6.5 months. We proposed that PRaG 3.0 might be a good therapeutic strategy for HER2-positive metastatic PDAC patients who failed from previous first-line approach and even PD-1 immunotherapy.
Citation	Kong YH, Xu ML, Zhang JJ, Chen GQ, Hong ZH, Zhang H, Dai XX, Ma YF, Zhao XR, Zhang CY, Chen RZ, Xing PF, Zhang LY. PRaG 3.0 therapy for human epidermal growth factor receptor 2-positive metastatic pancreatic ductal adenocarcinoma: A case report. World J Gastroenterol 2024; 30(9): 1237-1249

Received	2023-12-06 06:49
Peer-Review Started	2023-12-06 06:49
To Make the First Decision
Return for Revision	2024-01-04 09:38
Revised	2024-01-06 06:58
Second Decision	2024-02-04 03:02
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2024-02-04 04:53
Articles in Press	2024-02-04 04:53
Publication Fee Transferred
Edit the Manuscript by Language Editor
Typeset the Manuscript	2024-02-23 07:00

ISSN	1007-9327 (print) and 2219-2840 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Copyright	© The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Permissions	For details, please visit: http://www.wjgnet.com/bpg/gerinfo/207
Publisher	Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Website	http://www.wjgnet.com