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A 65-year-old woman with stage III LAPC (pMMR and PD-L1 CPS 30) received a BRICS regimen combining SBRT, toripalimab with nab-paclitaxel, low-dose chemotherapy, and anlotinib plus probiotics. Imaging demonstrated complete response with persistently normal tumor markers for five months without severe adverse events.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/complete-response-to-brics-in-locally-advanced-pancreatic-cancer-pmmr-cps-30-a-case-report/353623/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/complete-response-to-brics-in-locally-advanced-pancreatic-cancer-pmmr-cps-30-a-case-report/353623.png","ImageObject",300,407,{"name":92,"@type":93},"Hazel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What clinical problem does the case report address?","Question",{"text":112,"@type":113},"Locally advanced pancreatic cancer has a poor prognosis, and effective immunotherapeutic strategies are urgently needed for pMMR cases.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the patient treated in the BRICS regimen?",{"text":117,"@type":113},"The treatment included SBRT (24 Gy/3 fractions) followed by q21d toripalimab plus nab-paclitaxel, anlotinib (d1–14), and continuous Bifidobacterium triple viable tablets.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main outcomes and tolerability results?",{"text":121,"@type":113},"Imaging showed a complete response, tumor markers stayed normal for five months after therapy, and no severe adverse events were reported.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},353623,1790177284,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46},137441390410,"https://ap-avatar.wpscdn.com/avatar/2000252f4ab5702993?_k=1776741390130283984","TYPE Case Report  \nPUBLISHED 21 January 2026  \nDOI 10.3389/fimmu.2026.1743752  \nOPEN ACCESS  \nEDITED BY  \nDanlei Chen,  \nThe Affiliated Second Hospital of Anhui Medical University, China  \nREVIEWED BY  \nBingyu Li,  \nTongji University, China Atsushi Horiuchi,  \nEhime Prefectural Niihama Hospital, Japan  \n*CORRESPONDENCE  \nWeiqiang Fan  \n [630790845@qq.com](630790845@qq.com)[ ](630790845@qq.com)Yonghai Peng  \n [1208852065@qq.com](1208852065@qq.com)  \n†These authors have contributed equally to this work and share first authorship  \nRECEIVED 11 November 2025  \nREVISED 06 January 2026  \nACCEPTED 12 January 2026  \nPUBLISHED 21 January 2026  \nCITATION  \nYang S, Shao L, Wu Y, Peng Y and Fan W (2026) Complete response to BRICS in Locally advanced pancreatic cancer (pMMR, CPS 30): a case report.  \nFront. Immunol. 17:1743752 .  \ndoi: 10.3389/fimmu.2026.1743752  \nCOPYRIGHT  \n© 2026 Yang, Shao, Wu, Peng and Fan. This isan open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nComplete response to BRICS in Locally advanced pancreatic cancer (pMMR, CPS 30):  \na case report  \nSonglong Yang 1†, Liangxiu Shao 2†, Yating Wu 3, Yonghai Peng 3* and Weiqiang Fan 3*  \n1 Department of Spleen-Stomach-Hepatobiliary, Quanzhou Hospital of Traditional Chinese Medicine, Quanzhou, Fujian, China, 2 Department of Pathology, 900th Hospital of PLA Joint Logistic Support Force, Fuzhou, Fujian, China, 3 Department of Oncology, The CangShan District of the 900th Hospital, Fuzhou, Fujian, China  \nBackground: Locally advanced pancreatic cancer (LAPC) has a dismal prognosis, marked by an exceedingly low 5-year survival rate. While immune checkpoint inhibitors (ICIs) have demonstrated efficacy across various solid tumors, their application in the treatment of pancreatic ductal adenocarcinoma—particularly in mismatch repair–proficient (pMMR) cases—is restricted by the immunosuppressive nature of the tumor microenvironment (TME) . Thus, more effective treatment strategies for pMMR LAPC are urgently needed.  \nCase presentation: We present a 65-year-old female diagnosed with LAPC (cT4N1M0, Stage III), confir med pathologically as pancreatic ductaladenocarcinoma with pMMR status and a high programmed death-ligand 1 (PD-L1) combined positive score (CPS) of 30 . Initial tumor markers were significantly elevated (CA19-9: 62,228 . 8 U/L; CEA: 100 ng/mL) . The patient received a novel multimodal treatment referred to as the BRICS Regimen, an acronym derived from Bifidobacterium supplementation, Radiotherapy (hypofractionated), Immunotherapy (PD-1 inhibitors), Chemotherapy (lowdose), and Stereotactic approach. This protocol can be modified to match the individual disease characteristics. In this case, the treatment comprised SBRT 24 Gy/3 fractions → q21d toripalimab 240 mg + nab-paclitaxel 200→100 mg + anlotinib 12 mg d1–14, with continuous Bifidobacterium triple viable tablets. Imaging following treatment indicated a complete response (CR), and tumor markers remained normal for 5 months post-therapy. The treatment was well tolerated, with no severe adverse events reported.  \nConclusion: This report suggests that a combined modality approach—integrating SBRT, chemotherapy, antiangiogenic therapy, ICI, and probiotics—may achieve CR in patients presenting with pMMR LAPC and high PD-L1 expression, even without surgery. These results challenge the prevailing  \nFrontiers in Immunology 01 [frontiersin.org](frontiersin.org)  \nassumption that pMMR status invariably predicts resistance to immunotherapy. These findings suggest that, in pMMR pancreatic cancers with high PD-L1 CPS, multimodal treatment strategies may remo","cbCaijNfsUba5kEH","https://ap.wps.com/l/cbCaijNfsUba5kEH","pdf",1896332,"English","# Background\n# Case presentation\n# Conclusion\n# Keywords\n# Introduction","[{\"question\":\"What clinical problem does the case report address?\",\"answer\":\"Locally advanced pancreatic cancer has a poor prognosis, and effective immunotherapeutic strategies are urgently needed for pMMR cases.\"},{\"question\":\"How was the patient treated in the BRICS regimen?\",\"answer\":\"The treatment included SBRT (24 Gy/3 fractions) followed by q21d toripalimab plus nab-paclitaxel, anlotinib (d1–14), and continuous Bifidobacterium triple viable tablets.\"},{\"question\":\"What were the main outcomes and tolerability results?\",\"answer\":\"Imaging showed a complete response, tumor markers stayed normal for five months after therapy, and no severe adverse events were reported.\"}]","Complete response to BRICS in Locally advanced pancreatic cancer (pMMR, CPS 30) - a case report | PDF",1790106411]