Abstract
Advanced pancreatic ductal adenocarcinoma (PDAC) remains a challenging disease with limited treatment options. In this single-center retrospective study, we compared two first-line regimens in 52 patients with metastatic PDAC. Patients received either gemcitabine with nab-paclitaxel or the same chemotherapy combined with cadonilimab, a bispecific antibody targeting PD-1 and CTLA-4. Propensity score matching was applied to balance baseline characteristics. The results indicated that the addition of cadonilimab was associated with an improved median progression-free survival compared to chemotherapy alone. The safety profile of the combination regimen was manageable, with treatment-related adverse events comparable between groups. These findings provide evidence that integrating cadonilimab into standard chemotherapy may enhance treatment outcomes in advanced PDAC, highlighting a potential therapeutic strategy that merits further evaluation in prospective studies.