Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal solid malignancies, with high rates of early recurrence even after curative-intent surgery and optimal adjuvant chemotherapy. While immune checkpoint inhibitors targeting programmed death-1 have transformed outcomes in several cancers, their efficacy in advanced PDAC has been limited, largely due to a profoundly immunosuppressive tumor microenvironment. In this context, the real-world cohort study by Cao et al in the World Journal of Gastrointestinal Oncology explores the clinical value of combining programmed death-1 inhibition with adjuvant chemotherapy in patients with resected PDAC. The study reports a significant improvement in recurrence-free and distant metastasis-free survival without a concomitant increase in severe toxicity. This article critically appraises these findings in light of existing literature, discusses their biological plausibility, and outlines future directions for biomarker-driven, prospective evaluation of adjuvant immunotherapy in PDAC.

Based on the catalytic system consisting of a monodentate phosphine ligand and silver salt developed by our group, an asymmetric dearomative annulation of 3-difluoromethyl containing vinyl indoles with azodicarboxylates has been established to afford a series of difluoromethy containing chiral azapolycycles. This method provides an efficient access to chiral difluoromethylated dihydroindole derivatives with high yields, low catalyst loading, and good enantioselectivity.